Impact of vascular supply variability on the prognosis of meningioma patients: a retrospective study based on territory arterial spin labeling.

BACKGROUND

Territorial arterial spin labelling (t-ASL) could be an alternative method to digital subtraction angiography (DSA) when evaluating feeding arteries by previous reports, however, blood supply variations on meningioma prognosis remains unclear. In this study, the prognosis of meningiomas mainly supplied by the internal carotid artery (ICA) and external carotid artery (ECA) was compared, and relevant clinical factors were investigated.

METHODS

t-ASL technique was employed to categorized pathologically-confirmed meningioma patients into the ICA, ECA, ICA co-supplied, and non-ICA co-supplied group. Clinical data on symptoms, age, gender, location, volume, Simpson grade, pathological grading, Ki-67 expression, Glasgow Coma Score (GCS), and Karnofsky Performance Score (KPS) were collected. Correlation analysis was adopted to investigate the relationship between ICA-supplied meningiomas and clinical variables. Ridge regression analysis was used to evaluate various factors on prognosis.

RESULTS

Thirty-three cases (53.42±9.66 years, 8 males) included 3 World Health Organization (WHO) grade 2 and 30 grade 1 meningiomas. ICA group had a higher dizziness prevalence (71.43%) and lower scores on pre- and post-operative GCS and KPS. Headache was predominated in ECA group (80.00%). Correlation analysis showed significant associations between ICA-supplied meningiomas and male (r=0.398), dizziness (r=0.637), visual disturbance (r=0.352), as well as pre- and post-operative GCS and KPS. Ridge regression analysis revealed meningiomas with low pre-operative GCS [odds ratio (OR): 1.566], ICA blood supply (OR: 0.180), and WHO grade 2 (OR: 0.172) were associated with unfavorable prognosis.

CONCLUSIONS

Blood supply has correlations with clinical symptoms and prognosis of meningiomas. Dizziness and headache may be the distinctive symptoms in meningioma patients supplied by ICA and ECA. Meningiomas involving ICA supply, and with a high WHO grade may have unfavorable prognosis.