Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
World Neurosurg. 2024 Aug;188:e320-e325. doi: 10.1016/j.wneu.2024.05.106. Epub 2024 May 24.
Schwannomas and meningiomas are the most common intradural extramedullary spinal tumors; however, differentiating between them using magnetic resonance imaging (MRI) is a frequent challenge. In this study, we aimed to investigate the use of the contrast ratio (CR) as a quantitative MRI method in the differentiation of schwannomas and meningiomas.
We analyzed the data of patients with intradural extramedullary spinal tumors who underwent surgery and were diagnosed with either schwannomas or meningiomas by histopathological analysis. Regions of interest were set for the entire spinal tumor on T2-weighted sagittal MRI. To obtain the CR values of spinal tumors (CR), we used the signal intensity (SI) values of the tumor (SI) and spinal cord (SI) according to the following formula: [CR = (SI-SI)/(SI+SI)].
The study included 50 patients (23 males and 27 females) with a mean age of 61.5 years old (11-85 years old). Histopathological analysis revealed that 33 and 17 patients were diagnosed with schwannomas and meningiomas, respectively. The mean CR values of the schwannomas and meningiomas were 0.3040 ± 0.1386 and 0.0173 ± 0.1929, respectively. The CR value of the schwannomas was statistically significantly higher than that of meningiomas (P < 0.01). The cutoff CR value obtained from the receiver operating characteristic curve was 0.143, with a specificity and sensitivity of 90.9% and 88.2%, respectively. Furthermore, the value for the area under the receiver operating characteristic curve was 0.925 (95% confidence interval: 0.852-0.998).
The evaluation of CRs by using MRI to distinguish between schwannomas and meningiomas is a beneficial quantitative tool.
神经鞘瘤和脑膜瘤是最常见的硬脊膜外髓内脊髓肿瘤；然而，使用磁共振成像（MRI）进行区分是一个常见的挑战。在本研究中，我们旨在研究使用对比率（CR）作为一种定量 MRI 方法来区分神经鞘瘤和脑膜瘤。
我们分析了经手术和组织病理学分析诊断为神经鞘瘤或脑膜瘤的硬脊膜外髓内脊髓肿瘤患者的数据。在 T2 加权矢状位 MRI 上为整个脊髓肿瘤设置感兴趣区。为了获得脊髓肿瘤的 CR 值（CR），我们使用肿瘤（SI）和脊髓（SI）的信号强度（SI）值，根据以下公式：[CR =（SI-SI）/（SI+SI）]。
该研究包括 50 名患者（23 名男性和 27 名女性），平均年龄为 61.5 岁（11-85 岁）。组织病理学分析显示，33 名患者和 17 名患者分别诊断为神经鞘瘤和脑膜瘤。神经鞘瘤和脑膜瘤的平均 CR 值分别为 0.3040±0.1386 和 0.0173±0.1929。神经鞘瘤的 CR 值明显高于脑膜瘤（P<0.01）。从接受者操作特征曲线获得的截断 CR 值为 0.143，特异性和敏感性分别为 90.9%和 88.2%。此外，接受者操作特征曲线下的面积值为 0.925（95%置信区间：0.852-0.998）。
使用 MRI 评估 CR 值来区分神经鞘瘤和脑膜瘤是一种有益的定量工具。
