Lin Bon-Jour, Chou Kuan-Nein, Kao Hung-Wen, Lin Chin, Tsai Wen-Chiuan, Feng Shao-Wei, Lee Meei-Shyuan, Hueng Dueng-Yuan
Department of Neurological Surgery.
J Neurosurg. 2014 Nov;121(5):1201-8. doi: 10.3171/2014.7.JNS132359. Epub 2014 Aug 22.
This study investigated the specific preoperative MRI features of patients with intracranial meningiomas that correlate with pathological grade and provide appropriate preoperative planning.
From 2006 to 2012, 120 patients (36 men and 84 women, age range 20-89 years) with newly diagnosed symptomatic intracranial meningiomas undergoing resection were retrospectively analyzed in terms of radiological features of preoperative MRI. There were 90 WHO Grade I and 30 WHO Grade II or III meningiomas. The relationships between MRI features and WHO histopathological grade were analyzed and scored quantitatively.
According to the results of multivariate logistic regression analysis, age ≥ 75 years, indistinct tumorbrain interface, positive capsular enhancement, and heterogeneous tumor enhancement were identified factors in the prediction of advanced histopathological grade. The prediction model was quantified as a scoring scale: 2 × (age) + 5 × (tumor-brain interface) + 3 × (capsular enhancement) + 2 × (tumor enhancement). The calculated score correlated positively with the probability of high-grade meningioma.
This scoring approach may be useful for clinicians in determining therapeutic strategy and in surgical planning for patients with intracranial meningiomas.
本研究调查了颅内脑膜瘤患者与病理分级相关的术前MRI特征,并提供适当的术前规划。
回顾性分析2006年至2012年120例(男36例,女84例,年龄20 - 89岁)新诊断为有症状的颅内脑膜瘤并接受切除术患者的术前MRI放射学特征。其中有90例世界卫生组织(WHO)I级脑膜瘤和30例WHO II级或III级脑膜瘤。分析MRI特征与WHO组织病理学分级之间的关系并进行定量评分。
根据多因素逻辑回归分析结果,年龄≥75岁、肿瘤与脑界面不清、包膜强化阳性以及肿瘤强化不均匀是预测高级别组织病理学分级的因素。预测模型量化为评分量表:2×(年龄)+5×(肿瘤与脑界面)+3×(包膜强化)+2×(肿瘤强化)。计算出的分数与高级别脑膜瘤的概率呈正相关。
这种评分方法可能有助于临床医生为颅内脑膜瘤患者确定治疗策略和制定手术计划。