Tanaka Michihiro, Imhof Hans G, Schucknecht Bernhard, Kollias Spyros, Yonekawa Yasuhiro, Valavanis Anton
Institute of Neuroradiology and Department of Neurosurgery, University Hospital Zurich, Switzerland.
J Neurosurg. 2006 Mar;104(3):382-8. doi: 10.3171/jns.2006.104.3.382.
The extent of peritumoral brain edema (PTBE) associated with meningiomas can be highly variable. The authors studied the correlation between the development of efferent venous drainage from the tumor and the degree of PTBE that occurs in intracranial meningiomas.
Twenty-five patients with 27 intracranial supratentorial meningiomas were investigated to identify the correlation between the efferent venous drainage system of the tumor and peritumoral edema. The overall mean age of the patients was 54 years. Seventeen patients (68%) were female and eight (32%) were male. All patients underwent magnetic resonance imaging and digital subtraction angiography. In each meningioma, superselective angiography of the dominant feeding artery was performed, including the late venous phase to evaluate the development of the tumor's draining vein. An edema index (EI) was introduced to serve as an objective means by which to judge the extent of PTBE. Eleven meningiomas (41%), in which the mean EI was 0.14 +/- 0.10, clearly showed dominant draining veins originating from the tumor itself. In the other 16 meningiomas (59%), superselective angiography demonstrated no efferent venous drainage from the tumor, which could account for this group's mean EI value of 1.49 +/- 1.05 (p < 0.001).
The current results suggest that hypoplasia of the efferent draining vein from the meningioma itself contributes to PTBE formation. The development of an efferent venous system mitigates against the formation of PTBE. Intratumoral venous congestion can be considered the main cause of PTBE in meningiomas.
与脑膜瘤相关的瘤周脑水肿(PTBE)程度差异很大。作者研究了肿瘤传出静脉引流的发展与颅内脑膜瘤中发生的PTBE程度之间的相关性。
对25例患有27个颅内幕上脑膜瘤的患者进行研究,以确定肿瘤的传出静脉引流系统与瘤周水肿之间的相关性。患者的总体平均年龄为54岁。17例患者(68%)为女性,8例(32%)为男性。所有患者均接受了磁共振成像和数字减影血管造影。在每个脑膜瘤中,对主要供血动脉进行超选择性血管造影,包括静脉晚期以评估肿瘤引流静脉的发展。引入水肿指数(EI)作为判断PTBE程度的客观手段。11个脑膜瘤(41%),其平均EI为0.14±0.10,清楚地显示出源自肿瘤本身的优势引流静脉。在其他16个脑膜瘤(59%)中,超选择性血管造影显示肿瘤无传出静脉引流,这可以解释该组的平均EI值为1.49±1.05(p<0.001)。
目前结果表明,脑膜瘤本身传出引流静脉发育不全导致PTBE形成。传出静脉系统的发展可减轻PTBE的形成。瘤内静脉充血可被认为是脑膜瘤中PTBE的主要原因。