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非手术治疗的脑膜瘤的生长速率。

Growth rate of non-operated meningiomas.

作者信息

Zeidman L A, Ankenbrandt W J, Du Hongyan, Paleologos N, Vick N A

机构信息

Dept. of Neurology, Northwestern University, 710 N. Lake Shore Drive, Abbott Hall, 1115, Chicago, IL 60611, USA.

出版信息

J Neurol. 2008 Jun;255(6):891-5. doi: 10.1007/s00415-008-0801-2. Epub 2008 Mar 20.

Abstract

INTRODUCTION

Meningiomas are dural-based brain tumors that are typically histologically benign. Some meningiomas grow slowly or seemingly not at all with planimetric measurement. Volumetric measurement may be more accurate because tumors may grow in different directions than the planimetric axes.

METHODS

Twenty-one patients (with 22 tumors) had serial MRI brain scans available for review. We reviewed the charts and measured tumor dimensions on the MRI scans. Relative growth rates were calculated for volume and maximum initial diameter using published formulas. Patient demographics, tumor location, and special radiologic characteristics (calcification, T2 hypointensity, dural tail, mass effect, and midline shift) were compared to the volumetric growth rate.

RESULTS

Patients included 17 females and 4 males; age at diagnosis 36 to 74 years (mean 61). Follow-up was 2.08 to 10.83 years (mean 3.64). Most tumors were located in the convexity (27.27 %), sphenoid wing (27.27 %), or cerebellopontine angle (13.04 %). Two meningiomas (9.09 %) demonstrated no growth. The mean relative volumetric growth rate was 5.82 %/year, and planimetric was 2.00 %/year (difference 3.82 %/year, p-value < 0.0001). Convexity location had near significant association with slower relative volumetric growth. There were no significant associations between other tumor locations, age, gender, or radiologic characteristics and volumetric growth.

CONCLUSIONS

The mean volumetric growth rate was significantly greater than the planimetric growth rate, suggesting that volumetric measurement conveys more information and is superior in assessing tumor growth. This information could have clinical value in determining the frequency of follow-up imaging and the urgency of surgical intervention.

摘要

引言

脑膜瘤是起源于硬脑膜的脑肿瘤,组织学上通常为良性。一些脑膜瘤生长缓慢,通过平面测量似乎根本不生长。容积测量可能更准确,因为肿瘤可能朝着与平面测量轴不同的方向生长。

方法

21例患者(共22个肿瘤)有系列脑部MRI扫描图像可供回顾。我们查阅了病历,并在MRI扫描图像上测量肿瘤尺寸。使用已发表的公式计算体积和最大初始直径的相对生长率。将患者的人口统计学特征、肿瘤位置以及特殊的放射学特征(钙化、T2低信号、硬脑膜尾征、占位效应和中线移位)与容积生长率进行比较。

结果

患者包括17名女性和4名男性;诊断时年龄为36至74岁(平均61岁)。随访时间为2.08至10.83年(平均3.64年)。大多数肿瘤位于凸面(27.27%)、蝶骨嵴(27.27%)或桥小脑角(13.04%)。两个脑膜瘤(9.09%)无生长。平均相对容积生长率为每年5.82%,平面测量生长率为每年2.00%(差异为每年3.82%,p值<0.0001)。凸面位置与相对容积生长较慢有接近显著的相关性。其他肿瘤位置、年龄、性别或放射学特征与容积生长之间无显著相关性。

结论

平均容积生长率显著高于平面测量生长率,这表明容积测量能传达更多信息,在评估肿瘤生长方面更具优势。该信息在确定随访成像频率和手术干预紧迫性方面可能具有临床价值。

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