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Acta Neurochirurgica

, Volume 160, Issue 8, pp 1547–1553 | Cite as

Non-operative meningiomas: long-term follow-up of 136 patients

  • Rossana Romani
  • George Ryan
  • Christian Benner
  • Jonathan Pollock
Original Article - Brain Tumors
  • 139 Downloads

Abstract

Background

Improving access to neuroradiology investigations has led to an increased rate of diagnosis of incidental meningiomas.

Method

A cohort of 136 incidental meningioma patients collected by a single neurosurgeon in a single neurosurgical centre is retrospectively analysed between 2002 and 2016. Demographic data, imaging and clinical features are presented. The radiological factors associated with meningiomas progression are also presented.

Results

The mean age at diagnosis was 65 (range, 33–94) years. Univariate analysis showed oedema was most strongly correlated with progression (p = 0.010) followed by hyperintensity in T2-weighted (T2W) MRI (p = 0.029) and in Flair-T2W MRI (p = 0.017). Isointensity in Flair-T2W MRI (0.004) was most strongly correlated with non-progression of the meningioma followed by calcification (p = 0.007), older age (p = 0.087), hypointensity in Flair-T2W MRI (p = 0.014) sequences and in T2W MRI (p = 0.096). In multivariate analysis, the strongest radiological factor predictive of progression was peritumoural oedema (p = 0.016) and that of non-progression was calcification (p = 0.002). At the end of the median follow-up (FU) of 43 (range, 4–150) months, 109 (80%) patients remained clinically stable, 13 (10%) became symptomatic and 14 (10%) showed clinical and radiological progression.

Conclusions

One hundred and nine (80%) patients remained stable at the end of FU. Peritumoural oedema was predictive of meningiomas progression. Further prospective study is needed to identify the combination of factors which can predict the meningioma progression for an early surgery or early discharge.

Keywords

Calcification Incidental Magnetic resonance imaging Meningioma Natural history Oedema Progression 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures of this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurosurgery, Charing Cross HospitalImperial College NHS TrustLondonUK
  2. 2.Department of Neurosurgery, Essex Neuroscience CentreQueen’s HospitalRomfordUK
  3. 3.Department of Mathematics and StatisticsUniversity of HelsinkiHelsinkiFinland

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