1Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
2Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio; and.
Neurosurg Focus. 2022 May;52(5):E5. doi: 10.3171/2022.2.FOCUS21779.
The objective of this paper was to describe the volumetric natural history of meningiomas in patients with neurofibromatosis type 2 (NF2).
The authors performed a retrospective descriptive study by reviewing NF2 patients with meningiomas at their institution between 2000 and 2019. Demographic data were collected from the electronic medical records. Tumor volume was collected using volumetric segmentation software. Imaging characteristics including peritumoral brain edema (PTBE) and tumor calcification were collected for each patient from their first to most recent MRI at the authors' institution. An increase of 15% or more per year from original tumor size was used as the cutoff to define growth.
A total of 137 meningiomas from 48 patients were included in the analysis. The average number of tumors per person was 2.9. Ninety-nine (72.3%) tumors were in female patients. The median length of follow-up from first imaging to last imaging was 32 months (IQR 10.9, 68.3 months). Most tumors were located in the cerebral convexity (24.8%), followed by the falcine region (18.2%) and spine (10.2%). The median tumor growth was 0.12 cm3/yr (IQR 0.03, 0.52 cm3/yr). At the time of first imaging, 21.9% of tumors had calcifications, while 13.9% of meningiomas had PTBE. Of 137 tumors, 52 showed growth. Characteristics associated with tumor growth included PTBE (OR 9.12, 95% CI 1.48-56.4), tumor volume (per cm3) at first imaging (OR 0.91, 95% CI 0.83-0.99), and 10-year increased age at first imaging (OR 0.57, 95% CI 0.43-0.74). PTBE had the shortest median time to growth at 9.2 months.
Although the majority of NF2-associated meningiomas do not grow in the short term, a wide range of growth patterns can be seen. Younger age at first imaging and presence of PTBE are associated with growth. Patients with these characteristics likely benefit from closer follow-up.
本文旨在描述神经纤维瘤病 2 型（NF2）患者脑膜瘤的体积自然史。
作者通过回顾 2000 年至 2019 年在本机构就诊的 NF2 伴脑膜瘤患者进行回顾性描述性研究。从电子病历中收集人口统计学数据。使用体积分割软件收集肿瘤体积。从每位患者在本机构的首次至最近的 MRI 中收集肿瘤周围脑水肿（PTBE）和肿瘤钙化等影像学特征。将每年增长 15%或以上作为肿瘤生长的截止值。
共纳入 48 例患者的 137 个脑膜瘤。每人平均肿瘤数为 2.9 个。99 个（72.3%）肿瘤位于女性患者。从首次影像学到末次影像学的中位随访时间为 32 个月（IQR 10.9，68.3 个月）。大多数肿瘤位于大脑凸面（24.8%），其次是镰状突区域（18.2%）和脊柱（10.2%）。中位肿瘤生长为 0.12 cm3/yr（IQR 0.03，0.52 cm3/yr）。首次影像学时，21.9%的肿瘤有钙化，13.9%的脑膜瘤有 PTBE。在 137 个肿瘤中，有 52 个显示生长。与肿瘤生长相关的特征包括 PTBE（OR 9.12，95%CI 1.48-56.4）、首次影像学时的肿瘤体积（每 cm3）（OR 0.91，95%CI 0.83-0.99）和首次影像学时的 10 年年龄增长（OR 0.57，95%CI 0.43-0.74）。PTBE 的生长中位时间最短，为 9.2 个月。
尽管大多数 NF2 相关脑膜瘤在短期内不会生长，但也可以看到各种生长模式。首次影像学时年龄较小和存在 PTBE 与生长有关。具有这些特征的患者可能需要更密切的随访。
