Predictive Value of Heterogeneously Enhanced Magnetic Resonance Imaging Findings With Computed Tomography Evidence of Calcification for Severe Motor Deficits in Spinal Meningioma

Kosei Ono; Takayoshi Shimizu; Shunsuke Fujibayashi; Bungo Otsuki; Koichi Murata; Akio Sakamoto; Shuichi Matsuda

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자료유형: 학술저널

저자정보: Kosei Ono (Department of Orthopaedic Surgery Kyoto University Graduate School of Medicine) Takayoshi Shimizu (Department of Orthopaedic Surgery Kyoto University Graduate School of Medicine) Shunsuke Fujibayashi (Department of Orthopaedic Surgery Kyoto University Graduate School of Medicine) Bungo Otsuki (Department of Orthopaedic Surgery Kyoto University Graduate School of Medicine) Koichi Murata (Department of Orthopaedic Surgery Kyoto University Graduate School of Medicine) Akio Sakamoto (Department of Orthopaedic Surgery Kyoto University Graduate School of Medicine) Shuichi Matsuda (Department of Orthopaedic Surgery Kyoto University Graduate School of Medicine)

저널정보: 대한척추신경외과학회 Neurospine 대한척추신경외과학회지 제18권 제1호

발행연도: 2021.1

수록면: 163 - 169 (7page)

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Objective: Spinal meningioma is mostly benign, but they can exhibit neurological deficit. The relationship between neurological impairment and its radiographic findings, including intratumor magnetic resonance imaging (MRI) gadolinium enhancement and calcification in computed tomography (CT) scan, has not been studied. The purpose of this study was to investigate the association of preoperative image findings with neurological status in spinal meningioma. Methods: Patients histologically diagnosed with spinal meningioma (n=24), with an average age of 65.4 years, were included. The patients were classified into 2 groups, the homogeneous and heterogeneous groups, based on the contrast-enhanced T1-weighted MRI findings. Further, baseline demographics (age, sex, presence of preoperative paralysis [manual muscle testing 3 or worse neurological deficit in upper and/or lower limbs], tumor level, tumor length, and tumor occupation ratio), histological findings (Ki-67 index and histological subtypes), and CT findings (presence of intratumor calcification and Hounsfield unit [HU] value) were examined. Results: Preoperative paralysis was observed in 33.3% (8 of 24) of the patients. These patients exhibited frequent heterogeneous contrast-enhanced MRI findings than those without preoperative paralysis (57.1% vs. 14.3%, p=0.040). Further, preoperative paralysis did not associate with tumor level, tumor length, tumor-occupied ratio, Ki-67 index, and histological subtypes. The heterogeneous group showed 100% intratumor calcification and higher maximum HU than the homogeneous group (1,109.8 vs. 379.2, p=0.001). Conclusion: The heterogeneous contrast-induced MRI findings in the spinal meningioma were significantly associated with preoperative neurological impairment. Moreover, the intratumor contrast-deficient region in the heterogeneously enhanced tumors reflected marked calcification. The tumor hardness due to calcification may be related to preoperative neurological deficit.

#Spinal meningioma #Computed tomography #Magnetic resonance imaging #Calcification #Motor deficit

참고문헌 (17)

참고문헌 신청

Gelabert-González M / 2006 / Spinal meningiomas / Neurocirugia 17:125~131

Engelhard HH / 2010 / Clinical presentation, histology, and treatment in 430 patients with primary tumors of the spinal cord, spinal meninges, or cauda equina / Journal of neurosurgery. Spine 13:67~77

Westwick HJ / 2015 / Effects of sex on the incidence and prognosis of spinal meningiomas: a Surveillance, Epidemiology, and End Results study / Journal of neurosurgery. Spine 23:368~373

Kshettry VR / 2015 / Descriptive epidemiology of spinal meningiomas in the United States / Spine 40:E886~E889

Sandalcioglu IE / 2008 / Spinal meningiomas: critical review of 131 surgically treated patients / Eur Spine J 17:1035~1041

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이 논문의 저자 정보

Kosei Ono

소속기관 Department of Orthopedic Surgery Kurashiki Central Hospital

주요연구분야 의약학 > 임상의학 > 신경외과학

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Takayoshi Shimizu