Masuda Hiroyuki, Nemoto Masaaki, Harada Naoyuki, Fuchinoue Yutaka, Okonogi Shinichi, Node Yasuhiro, Ando Shunpei, Kondo Kosuke, Sugo Nobuo
Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University , Tokyo , Japan.
Br J Neurosurg. 2019 Oct;33(5):522-527. doi: 10.1080/02688697.2019.1617405. Epub 2019 May 17.
Central nervous system (CNS) tumour consistency is one of the factors determining the difficulty of surgery for such lesions. We measured the consistency of surgically excised CNS tumour specimens using a hardness meter. The purpose of this study was to identify imaging parameters that reflect tumour consistency by comparing preoperative imaging findings with CNS tumour consistency measurements. Of 175 consecutive patients with CNS tumours who underwent surgery at our hospital between October 2012 and October 2018, 127 were included in this study (those whose specimens were difficult to measure were excluded). CNS tumour consistency was measured immediately after surgical excision using a hardness meter and compared with preoperative T1-weighted, T2-weighted (T2WI), fluid attenuated inversion recovery (FLAIR), diffusion-weighted imaging, gadolinium-enhanced magnetic resonance imaging, plain computed tomography (CT), and contrast-enhanced CT findings. Tumour consistency was also subjectively classified by the surgeon into soft, hard, or very hard. The intracranial meningiomas were harder than the metastatic tumours and gliomas ( = 0.03 and = 0.03, respectively). Among the intracranial meningiomas, the tumours that exhibited high intensity on T2WI were softer than those that displayed isointensity or low intensity ( < 0.001 and < 0.001, respectively), and the isointense tumours were softer than the low intensity tumours ( = 0.02). Among the metastatic tumours, the tumours that exhibited high intensity on T2WI were softer than those that displayed isointensity or low intensity ( < 0.001 and < 0.001, respectively). Among the intracranial meningiomas and metastatic tumours, significant correlations were detected between the T2WI findings and subjective tumour consistency according to the surgeon or quantitative tumour consistency ( = 0.01 and = 0.03, respectively). The preoperative T2WI findings of intracranial meningiomas and metastatic tumours were significantly correlated with quantitatively measured tumour consistency and subjectively evaluated tumour consistency. Therefore, we concluded that T2WI findings are useful for preoperatively predicting the consistency of such tumours.
中枢神经系统（CNS）肿瘤的质地是决定此类病变手术难度的因素之一。我们使用硬度计测量了手术切除的CNS肿瘤标本的质地。本研究的目的是通过比较术前影像学表现与CNS肿瘤质地测量结果，确定反映肿瘤质地的影像学参数。在2012年10月至2018年10月期间于我院接受手术的175例连续CNS肿瘤患者中，127例纳入本研究（排除标本难以测量的患者）。使用硬度计在手术切除后立即测量CNS肿瘤质地，并与术前T1加权、T2加权（T2WI）、液体衰减反转恢复（FLAIR）、扩散加权成像、钆增强磁共振成像、平扫计算机断层扫描（CT）和增强CT表现进行比较。外科医生还将肿瘤质地主观分类为软、硬或非常硬。颅内脑膜瘤比转移瘤和胶质瘤更硬（分别为 = 0.03和 = 0.03）。在颅内脑膜瘤中，T2WI上表现为高信号的肿瘤比等信号或低信号的肿瘤更软（分别为 < 0.001和 < 0.001），等信号肿瘤比低信号肿瘤更软（ = 0.02）。在转移瘤中，T2WI上表现为高信号的肿瘤比等信号或低信号的肿瘤更软（分别为 < 0.001和 < 0.001）。在颅内脑膜瘤和转移瘤中，根据外科医生的主观判断或定量肿瘤质地，T2WI表现与肿瘤质地之间均检测到显著相关性（分别为 = 0.01和 = 0.03）。颅内脑膜瘤和转移瘤的术前T2WI表现与定量测量的肿瘤质地和主观评估的肿瘤质地显著相关。因此，我们得出结论，T2WI表现有助于术前预测此类肿瘤的质地。
