Department of Neurosurgery, Tokyo Medical University, Nishi-Shinjuku, Shinjuku-ku, Tokyo, Japan.
Department of Neurosurgery, Tokyo Medical University, Nishi-Shinjuku, Shinjuku-ku, Tokyo, Japan.
World Neurosurg. 2022 Jun;162:e178-e186. doi: 10.1016/j.wneu.2022.02.118. Epub 2022 Mar 3.
Preoperative embolization for intracranial meningiomas can cause tumor necrosis, reduce intraoperative blood loss, and facilitate surgery. This study aimed to evaluate the efficacy of tumor embolization using Embosphere microspheres for skull base meningiomas and analyze postembolization plain computed tomography (CT) and magnetic resonance imaging (MRI) scans to identify findings that could potentially predict treatment response.
Between April 2014 and April 2020, 80 patients with skull base meningiomas presenting at our medical center underwent embolization with Embosphere microspheres. The effects of tumor embolization were evaluated through a comparison of postembolization plain CT and contrast-enhanced MRI.
A total of 143 vessels (102 of 108 external carotid artery branches and 41 of 65 internal carotid artery branches) from 80 skull base meningiomas were embolized with Embosphere microspheres. Microspheres 100-300 μm in size were used in 2 cases, microspheres 300-500 μm in size were used in 12 cases, and microspheres 500-700 μm in size were used in 66 cases. Postembolization contrast-enhanced MRI showed reductions in enhancing lesions within the tumor in 55 of 80 cases. Postembolization plain CT scans showed high-density lesions within the tumor in 41 of 55 cases. Thus, reductions in enhancing lesions on postembolization contrast-enhanced MRI were statistically significantly associated with the presence of high-density lesions on postembolization plain CT (P < 0.001). Embolization-related neurological complications occurred in 3 cases.
Embosphere microspheres are user friendly and effective embolic materials for the embolization of skull base meningiomas. Postembolization contrast-enhanced MRI and plain CT findings may be useful for evaluating the effects of tumor embolization.
颅内脑膜瘤术前栓塞可以引起肿瘤坏死，减少术中出血量，便于手术。本研究旨在评估使用 Embosphere 微球进行颅底脑膜瘤栓塞的疗效，并分析栓塞后平扫 CT 和磁共振成像 (MRI) 扫描结果，以确定可能预测治疗反应的发现。
2014 年 4 月至 2020 年 4 月，我院收治的 80 例颅底脑膜瘤患者行 Embosphere 微球栓塞治疗。通过栓塞后平扫 CT 和增强 MRI 比较评估肿瘤栓塞效果。
80 例颅底脑膜瘤的 143 支血管（108 支颈外动脉分支中的 102 支和 65 支颈内动脉分支中的 41 支）用 Embosphere 微球栓塞。2 例使用 100-300μm 微球，12 例使用 300-500μm 微球，66 例使用 500-700μm 微球。栓塞后增强 MRI 显示 80 例中有 55 例肿瘤内增强病变缩小。栓塞后平扫 CT 显示 55 例中有 41 例肿瘤内高密度病变。因此，栓塞后增强 MRI 上增强病变的减少与栓塞后平扫 CT 上高密度病变的存在具有统计学显著相关性（P<0.001）。3 例出现与栓塞相关的神经并发症。
Embosphere 微球是一种方便易用的栓塞材料，可有效栓塞颅底脑膜瘤。栓塞后增强 MRI 和平扫 CT 结果可能有助于评估肿瘤栓塞效果。
