Novel method to evaluate the risk of tumor adhesions and post-operative hemorrhage of meningiomas using 320 row CT-DSA: A clinical research study.
Adult
Aged
Dura Mater
/ blood supply
Female
Four-Dimensional Computed Tomography
/ methods
Humans
Male
Meningeal Neoplasms
/ diagnostic imaging
Meningioma
/ diagnostic imaging
Middle Aged
Neovascularization, Pathologic
/ diagnostic imaging
Neurosurgical Procedures
/ adverse effects
Postoperative Hemorrhage
/ diagnostic imaging
Tissue Adhesions
/ diagnostic imaging
320-row CT
Brain adhesion
CT-DSA
Meningioma
Pial feed
Postoperative hemorrhage
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
12
02
2020
accepted:
13
03
2020
pubmed:
18
4
2020
medline:
5
2
2021
entrez:
18
4
2020
Statut:
ppublish
Résumé
Meningioma is an extra-axial tumor that forms adhesions toward the brain surface in the course of its growth. Predicting adhesions between the tumor and the brain surface leads to better predictions of surgical results. There are few studies on brain-tumor adhesions or postoperative hemorrhage. This study aimed to assess tumor vascularity of the dura and cerebral surface, and predict surgical outcomes using four-dimensional computed tomography angiography (4D CTA). Using a dynamic contrast CT, we conducted a retrospective study of 27 patients with convexity (n = 15), falx (n = 6), and parasagittal (n = 6) meningiomas treated in our hospital from January 2016 to September 2018. We set the region of interest on the dural layer and cerebral surface side of meningiomas and calculated the mean CT value in each region. Distribution of blood flow in the tumor was classified into two groups: A, which has a higher CT value of the dural side than that of the brain surface side at every timing, and B, which meets the criteria other than those in group A. Demographic data, preoperative characteristic images, and postoperative complications were compared between the groups. Twelve and 15 patients were classified into groups A and B, respectively. The extent of adhesions against the cerebral cortex in group A was significantly less severe compared with that in group B (p = 0.038). The rate of postoperative hemorrhage occurrence in group B (53%) was significantly higher than that in group A (8%) (p = 0.04). There were no significant differences in the other preoperative characteristic images or perioperative parameters between groups A and B. A 320-row dynamic contrast CT scanner can detect meningiomas with a high probability of severe adhesion toward the brain surface and postoperative intraparenchymal hematoma.
Identifiants
pubmed: 32300986
doi: 10.1007/s00701-020-04295-9
pii: 10.1007/s00701-020-04295-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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