Department of Neurosurgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
J Neurooncol. 2013 Jan;111(1):49-57. doi: 10.1007/s11060-012-0989-y. Epub 2012 Oct 27.
Various degrees of peritumoral brain edema (PTBE) are observed in patients with intracranial meningiomas. Factors affecting the occurrence of PTBE in intracranial meningioma were investigated. PTBE was investigated retrospectively for 110 patients with primary intracranial meningiomas. Predictive factors related to PTBE were analyzed, for example patient age, sex, magnetic resonance imaging features (contrast enhancement, tumor shape, tumor location, tumor volume), angiographical features (tumor stain, pial-cortical arterial supply, venous obstruction), and histopathological features (histological subtypes, mindbomb homolog 1 labeling index (MIB1-LI)). Histological subtypes were classified into World Health Organization (WHO) grade I common type (meningothelial, transitional, fibrous), grade I uncommon type, and grade II and III types. The extent of PTBE was assessed by calculation of the edema index (EI). PTBE was present in 53 cases (48 %). Male sex, heterogeneous enhancement, superficial location, tumor volume (≥10 cm(3)), remarkable tumor stain, pial supply, venous obstruction, malignant pathology, and MIB1-LI ≥4 % were correlated with PTBE in univariate analysis. Pial supply and remarkable tumor stain were correlated with PTBE in multivariate analysis. WHO grade I uncommon type had obviously higher EI than WHO grade I common type, and WHO grade II and III types (P < 0.001). Seven cases with prominently high EI (EI ≥10) were all WHO grade I uncommon type, including angiomatous, microcystic, secretory, and lymphoplasmacyte-rich meningioma. Prominently extensive PTBE might indicate the presence of WHO grade I uncommon type meningioma.
颅内脑膜瘤患者存在不同程度的瘤周脑水肿（PTBE）。研究了影响颅内脑膜瘤 PTBE 发生的因素。回顾性研究了 110 例原发性颅内脑膜瘤患者的 PTBE。分析了与 PTBE 相关的预测因素，例如患者年龄、性别、磁共振成像特征（增强、肿瘤形状、肿瘤位置、肿瘤体积）、血管造影特征（肿瘤染色、皮质动脉供应、静脉阻塞）和组织病理学特征（组织学亚型、mindbomb 同源物 1 标记指数（MIB1-LI））。组织学亚型分为世界卫生组织（WHO）I 级常见型（脑膜瘤、过渡型、纤维型）、I 级罕见型和 II 级和 III 级。通过计算水肿指数（EI）评估 PTBE 的程度。53 例（48%）存在 PTBE。单因素分析显示，男性、不均匀增强、表浅位置、肿瘤体积（≥10cm³）、显著肿瘤染色、皮质动脉供应、静脉阻塞、恶性病理和 MIB1-LI≥4%与 PTBE 相关。多因素分析显示皮质动脉供应和显著肿瘤染色与 PTBE 相关。WHO I 级罕见型的 EI 明显高于 WHO I 级常见型和 II 级和 III 级（P<0.001）。7 例 EI 明显升高（EI≥10）均为 WHO I 级罕见型，包括血管性、微囊型、分泌型和淋巴浆细胞丰富型脑膜瘤。显著广泛的 PTBE 可能提示存在 WHO I 级罕见型脑膜瘤。
