Watanabe Keita, Kakeda Shingo, Yamamoto Junkoh, Ide Satoru, Ohnari Norihiro, Nishizawa Shigeru, Korogi Yukunori
Department of Radiology, University of Occupational and Environmental Health School of Medicine, Japan
Department of Radiology, University of Occupational and Environmental Health School of Medicine, Japan.
Acta Radiol. 2016 Mar;57(3):333-40. doi: 10.1177/0284185115578323. Epub 2015 Mar 29.
From a surgical perspective, presurgical prediction of meningioma consistency is beneficial.
To quantitatively analyze the correlation between the magnetic resonance (MR) signal intensity (SI) or apparent diffusion coefficient (ADC) and meningioma consistency and to determine which MR sequence could help predicting hard meningiomas.
This study included 43 patients with meningiomas who underwent preoperative MR imaging (MRI), including T1-weighted (T1W) imaging, T2-weighted (T2W) imaging, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI), contrast-enhanced (CE)-T1W imaging, and CE-fast imaging employing steady-state acquisition (FIESTA). A neurosurgeon evaluated the tumor consistency using a visual analog scale (VAS) with the anchors "soft" (score = 0) and "hard" (score = 10). The SI ratio (tumor to cerebral cortex SI) and ADC value were compared with the tumor consistency. The sensitivity, specificity, and accuracy for predicting hard meningiomas (VAS score ≥8; 9 of 43 patients) were calculated using cutoff values for the SI ratio that were obtained in a receiver operating characteristic curve analysis.
A significant negative correlation was observed between the tumor consistency and the SI ratio on T2W imaging, FLAIR, and CE-FIESTA (P < 0.05) but not on T1W imaging, CE-T1W imaging, and the ADC value. The sensitivity, specificity, and accuracy for predicting hard meningiomas were 89%, 79%, and 81% with T2W imaging; 89%, 76%, and 79% with FLAIR; and 100%, 74%, and 79% with CE-FIESTA, respectively.
Our results suggest that a quantitative assessment using conventional T2W imaging or FLAIR may be a simple and useful method for predicting hard meningiomas.
从外科手术角度来看，术前预测脑膜瘤的质地是有益的。
定量分析磁共振（MR）信号强度（SI）或表观扩散系数（ADC）与脑膜瘤质地之间的相关性，并确定哪种MR序列有助于预测质地硬的脑膜瘤。
本研究纳入了43例接受术前MR成像（MRI）的脑膜瘤患者，成像序列包括T1加权（T1W）成像、T2加权（T2W）成像、液体衰减反转恢复（FLAIR）序列、扩散加权成像（DWI）、对比增强（CE）-T1W成像以及稳态采集快速成像（FIESTA）。一名神经外科医生使用视觉模拟量表（VAS）评估肿瘤质地，量表两端分别为“软”（评分=0）和“硬”（评分=10）。将SI比值（肿瘤与大脑皮质SI之比）和ADC值与肿瘤质地进行比较。使用在受试者工作特征曲线分析中获得的SI比值截断值，计算预测质地硬的脑膜瘤（VAS评分≥8；43例患者中的9例）的敏感性、特异性和准确性。
在T2W成像、FLAIR序列和CE-FIESTA序列上，观察到肿瘤质地与SI比值之间存在显著负相关（P<0.05），而在T1W成像、CE-T1W成像和ADC值上未观察到显著相关性。预测质地硬的脑膜瘤时，T2W成像的敏感性、特异性和准确性分别为89%、79%和81%；FLAIR序列分别为89%、76%和79%；CE-FIESTA序列分别为100%、74%和79%。
我们的结果表明，使用传统T2W成像或FLAIR序列进行定量评估可能是预测质地硬的脑膜瘤的一种简单且有用的方法。
