Evaluation of Epidemiologic Factors, Radiographic Features, and Pathologic Findings for Predicting Peritumoral Brain Edema in Meningiomas

• Published in: Journal of magnetic resonance imaging Vol. 52; no. 1; pp. 174 - 182
• Main Authors: Sapkota, Mani R., Yang, Zonghe, Zhu, Dan, Zhang, Yan, Yuan, Tengfei, Gao, Junfeng, Si, Tongguo, Wang, Junping
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.07.2020; Wiley Subscription Services, Inc
• Subjects: Body weight; Brain; Brain cancer; brain edema; Brain Edema - diagnostic imaging; Brain Edema - epidemiology; Calcification; Cerebrospinal fluid; Confidence intervals; Edema; Epidemiologic Factors; Epidemiology; Evaluation; Field strength; Gadolinium; Humans; Magnetic Resonance Imaging; Medical imaging; Meningeal Neoplasms - complications; Meningeal Neoplasms - diagnostic imaging; Meningioma; Meningioma - complications; Meningioma - diagnostic imaging; Multivariate analysis; Neuroimaging; Patients; Regression analysis; Retrospective Studies; Scanners; Skull; Statistical analysis; Statistical tests; Surgery; X‐ray computed tomography; meningioma; brain edema; magnetic resonance imaging; X-ray computed tomography
• ISSN: 1053-1807; 1522-2586; 1522-2586
• DOI: 10.1002/jmri.27046

Background Despite several treatment options that are available for meningiomas, surgery is the only method currently practiced. Peritumoral brain edema (PTBE) in meningiomas causes difficulty marginalizing the dissection in an intraoperative setting. Purpose To evaluate whether the epidemiological variables, imaging characteristics, and pathologic parameters are correlated with the presence of PTBE in meningiomas. Study Type Retrospective study from 2015 to 2018. Subjects In all, 550 patients with histopathologically confirmed meningioma were included. After exclusion of patients with extradural, spinal, and intraventricular meningiomas and those with image artifacts, a total of 441 patients were included in the final analysis. Field Strength/Sequence Images were performed with 3T MR scanners and axial/sagittal T1WI, axial/coronal T2WI and axial/sagittal/coronal contrast‐enhanced T1WI after administration of 0.1 mmol/kg of body weight of Gd‐DTPA. Assessment Fourteen variables were patients' age, sex, skull changes, calcification, density, location, margin, volume, cerebrospinal fluid (CSF) cleft, signal intensity (SI) on T2WI, degree and pattern of contrast enhancement, WHO histological classification, and Ki‐67 labeling index. Statistical Tests The relationship between each factor and the formation of PTBE was examined by multivariate logistic regression analysis. Results After multivariate logistic regression, the absence of CSF cleft (odds ratio [OR]: 63.43, 95% confidence interval [CI]: 27.24–121.42, P = 1.2 × 10−8), non‐skull base location (OR: 15.32, 95% CI: 5.81–28.23, P = 0.0008), high SI on T2WI (OR: 5.05, 95% CI: 2.27–14.88, P = 0.01), and G I uncommon subtypes (OR: 4.75, 95% CI: 1.42–15.94, P = 0.01) were found to be significant independent factors associated with the occurrence of PTBE in meningiomas. In patients with PTBE‐positive meningiomas, there was no significant correlation between the volume of PTBE and the volume of the tumor (r = 0.17, P = 0.60). Data Conclusion These factors may be suggestive of anticipating the formation of PTBE. Level of Evidence: 3 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;52:174–182.