Nakajima Norio, Fukuda Hitoshi, Adachi Hiromasa, Sasaki Natsuhi, Yamaguchi Makoto, Mitsuno Yuto, Kitagawa Masashi, Horikawa Fumihiko, Murao Kenichi, Yamada Keisuke
Department of Neurosurgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.
Department of Neurosurgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.
World Neurosurg. 2017 Sep;105:591-598. doi: 10.1016/j.wneu.2017.06.047. Epub 2017 Jun 15.
Preoperative endovascular embolization of intracranial meningiomas denatures the tumor tissue, reduces intraoperative blood loss, and facilitates surgical removal. However, as most meningiomas are surgically removed within a few days after embolization, the effect of long-term volume reduction of the tumor due to the endovascular embolization remains unknown.
Five patients with intracranial meningioma underwent endovascular embolization between January 2006 and December 2014 and were followed without surgical resection for >14 days. The reduction in tumor and peritumoral edema volumes on sequential head magnetic resonance imaging, along with the clinical symptoms, were retrospectively reviewed.
All the tumors indicated a 10%-30% volume reduction 30 days after embolization, which continued thereafter; no meningioma regrowth was observed for >90 days in 2 of 5 cases. Moreover, the peritumoral edema volume was reduced by 30%-70% at 30 days after embolization, and no subsequent increase was observed for >60 days in 4 of 5 cases. The neurologic symptoms related to the tumor mass effect improved after embolization.
Endovascular embolization of intracranial meningiomas with n-butyl cyanoacrylate reduced the tumor and peritumoral edema volumes by 10%-30% and 30%-70%, respectively, within 30 days. Volume and edema reduction effect of embolization may last longer than expected, beyond the timing when most meningiomas are resected after embolization. In this study, we described our preliminary results of the volume reduction of intracranial meningiomas that were embolized using n-butyl cyanoacrylate and monitored without any surgical resection for >14 days. We believe that our study makes a significant contribution to the literature because we showed that volume and edema reduction effect of embolization may last longer than expected, beyond the timing when most meningiomas are resected after embolization.
颅内脑膜瘤术前血管内栓塞可使肿瘤组织变性，减少术中失血，并便于手术切除。然而，由于大多数脑膜瘤在栓塞后几天内即接受手术切除，血管内栓塞对肿瘤长期体积缩小的影响尚不清楚。
2006年1月至2014年12月期间，5例颅内脑膜瘤患者接受了血管内栓塞治疗，并在未进行手术切除的情况下随访超过14天。回顾性分析连续头颅磁共振成像上肿瘤及瘤周水肿体积的缩小情况以及临床症状。
所有肿瘤在栓塞后30天体积缩小10% - 30%，此后持续缩小；5例中有2例在超过90天内未观察到脑膜瘤复发。此外，栓塞后30天瘤周水肿体积减少30% - 70%，5例中有4例在超过60天内未观察到水肿体积随后增加。与肿瘤占位效应相关的神经症状在栓塞后有所改善。
用氰基丙烯酸正丁酯进行颅内脑膜瘤血管内栓塞，在30天内可分别使肿瘤及瘤周水肿体积缩小10% - 30%和30% - 70%。栓塞的体积缩小和水肿减轻效果可能比预期持续时间更长，超过大多数脑膜瘤在栓塞后进行切除的时间。在本研究中，我们描述了使用氰基丙烯酸正丁酯栓塞并在未进行任何手术切除的情况下监测超过14天的颅内脑膜瘤体积缩小的初步结果。我们认为我们的研究对文献有重大贡献，因为我们表明栓塞的体积缩小和水肿减轻效果可能比预期持续时间更长，超过大多数脑膜瘤在栓塞后进行切除的时间。
