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Novel method to evaluate the risk of tumor adhesions and post-operative hemorrhage of meningiomas using 320 row CT-DSA: A clinical research study

  • Original Article - Tumor - Meningioma
  • Published:
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Abstract

Objective

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).

Patients and methods

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.

Results

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.

Conclusion

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.

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Abbreviations

4D :

four-dimensional

AV :

arteriovenous

CT :

computed tomography

DSA :

digital subtraction angiography

HIA :

high-intensity area

MRI :

magnetic resonance imaging

N.S. :

nonsignificant

ROI :

region of interest

WHO :

World Health Organization

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Authors and Affiliations

  1. Department of Neurosurgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, Japan

    Nobuhiko Arai, Katsuhiro Mizutani, Takashi Horiguchi, Takenori Akiyama, Satoshi Takahashi, Kaoru Yanagisawa, Kazunari Koike & Kazunari Yoshida

Authors
  1. Nobuhiko Arai
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  2. Katsuhiro Mizutani
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  3. Takashi Horiguchi
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  4. Takenori Akiyama
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  5. Satoshi Takahashi
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  6. Kaoru Yanagisawa
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  7. Kazunari Koike
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  8. Kazunari Yoshida
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Correspondence to Nobuhiko Arai.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Keio University ethical 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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This article is part of the Topical Collection on Tumor – Meningioma

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Arai, N., Mizutani, K., Horiguchi, T. et al. Novel method to evaluate the risk of tumor adhesions and post-operative hemorrhage of meningiomas using 320 row CT-DSA: A clinical research study. Acta Neurochir 162, 2145–2153 (2020). https://doi.org/10.1007/s00701-020-04295-9

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  • DOI: https://doi.org/10.1007/s00701-020-04295-9

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