未治疗的海绵窦脑膜瘤的体积增长率。
Volumetric growth rates of untreated cavernous sinus meningiomas.
机构信息
1Department of Neurosurgery, University of Miami, Miami, Florida; and.
2Department of Neurosurgery, NYU Langone Medical Center, New York, New York.
出版信息
J Neurosurg. 2021 Aug 20;136(3):749-756. doi: 10.3171/2021.2.JNS203485. Print 2022 Mar 1.
OBJECTIVE
Meningiomas that arise primarily within the cavernous sinus are often believed to be more indolent in their growth pattern. Despite this perceived growth pattern, disabling symptoms can arise even with small tumors. While research has been done on cavernous sinus meningiomas (CSMs) and their treatment, very little is known about their natural growth rates. With a better understanding of the growth rate of CSM, patient treatment and guidance can be can optimized and individualized. The goal of this study was to determine volumetric growth rates of untreated CSMs.
METHODS
Thirty-seven patients with 166 MR images obtained between May 2004 and September 2019 were reviewed, with a range of 2-13 MR images per patient (average of 4.5 MR images per patient). These scans were obtained over an average follow-up period of 45.9 months (median 33.8, range 2.8-136.9 months). All imaging prior to any intervention was included in this analysis. Volumetric measurements were performed and assessed over time.
RESULTS
The estimated volumetric growth rate was 23.3% per year (95% CI 10.2%-38.0%, p < 0.001), which is equivalent to an estimated volume doubling time (VDT) of 3.3 years (95% CI 2.1-7.1 years). There was no significant relationship between growth rate and patient age (p = 0.09) or between growth rate and patient sex (p = 0.78). The median absolute growth rate was 41% with a range of -1% to 1793%. With a definition of "growth" as an increase of greater than 20% during the observed period, 65% of tumors demonstrated growth within their observation interval. Growth rates for each tumor were calculated and tumors were segmented based on growth rate. Of 37 patients, 22% (8) demonstrated no growth (< 5% annual growth, equivalent to a VDT > 13.9 years), 32% (12) were designated as slow growth (annual growth rate 5%-20%, VDT 3.5-13.9 years), 38% (14) were found to have medium growth (annual growth rate 20%-100%, VDT 0.7-3.5 years), and 8% were considered fast growing (annual growth rate > 100%, VDT < 0.7 years).
CONCLUSIONS
This study evaluated CSM volumetric growth rates. A deeper understanding of the natural history of untreated CSMs allows for better counseling and management of patients.
目的
原发性发生在海绵窦内的脑膜瘤，其生长模式通常被认为更为惰性。尽管存在这种生长模式，但即使肿瘤较小，也可能出现致残症状。虽然已经对海绵窦脑膜瘤（CSM）及其治疗进行了研究，但对其自然生长率知之甚少。通过更好地了解 CSM 的生长速度，可以优化和个体化患者的治疗和指导。本研究的目的是确定未经治疗的 CSM 的体积增长率。
方法
回顾了 2004 年 5 月至 2019 年 9 月期间 37 名患者的 166 份 MRI 图像，每位患者的 MRI 图像数量为 2-13 份（平均每位患者 4.5 份 MRI 图像）。这些扫描的平均随访时间为 45.9 个月（中位数 33.8，范围 2.8-136.9 个月）。所有在任何干预之前的影像学资料都包括在本分析中。进行了体积测量并随时间进行评估。
结果
估计的体积年增长率为 23.3%（95%CI 10.2%-38.0%，p<0.001），相当于估计的体积倍增时间（VDT）为 3.3 年（95%CI 2.1-7.1 年）。生长率与患者年龄（p=0.09）或患者性别（p=0.78）之间无显著关系。中位绝对生长率为 41%，范围为-1%至 1793%。以观察期内增长率大于 20%为“生长”的定义，65%的肿瘤在其观察期内有生长。计算了每个肿瘤的生长率，并根据生长率对肿瘤进行了分割。在 37 名患者中，22%（8 名）无生长（<5%的年增长率，相当于 VDT>13.9 年），32%（12 名）为生长缓慢（年增长率 5%-20%，VDT 3.5-13.9 年），38%（14 名）为中度生长（年增长率 20%-100%，VDT 0.7-3.5 年），8%被认为是快速生长（年增长率>100%，VDT<0.7 年）。
结论
本研究评估了 CSM 的体积增长率。更深入地了解未经治疗的 CSM 的自然史，可以更好地为患者提供咨询和管理。
Zotero 插件