Computerized Tomography Scanning Appearances of Intracranial Meningiomas

Vassalouthis, J.; Ambrose, James; Burke, Dennis P.

doi:10.1097/00004728-198002000-00032

Cited by 11 publications

(14 citation statements)

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“…Though malignant meningiomas have also been related with a higher incidence of brain oedema [6,7,38], the differences did not reach statistical significance, neither in the present study nor in other series [2,33]. In fact, the analysis of the possible influence of histological factors such as turnout cellularity [6,13,22,34,47], mitotic index [6,13,14,22,24,33,47,49,51], vascularization [6,22,34,47,49,52], necrosis [51], or infiltration of the underlying cerebral cortex [16,22,49] on brain oedema formation has yielded contradictory results. However, it should be noted that disagreement between studies may be due in part, to the different criteria used to analyse the variable under 491 consideration.…”

Section: Histopathological Factorscontrasting

confidence: 75%

“…The presence of either irregular tumour margins, or fringes and "mushrooming" projecting into the brain parenchyma in patients with intracranial meningiomas, has been related with infiltration of the underlying cerebral cortex and a malignant behaviour [16,36,37,51]. In our series, meningiomas showing irregular margins associated with a significantly higher incidence of brain oedema than those showing smooth margins, and the presence of irregular margins increased by a factor of 2.9 the risk for developing associated brain oedema.…”

Section: Ct Findings (Skull Changes Tumour Calcification Intensity mentioning

confidence: 46%

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Brain oedema in patients with intracranial meningioma

Lobato¹,

Alday²,

Gómez³

et al. 1996

Acta neurochir

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The authors analysed the correlation between different clinical, radiological, and pathological variables and the presence and intensity of brain oedema associated to intracranial meningioma in 400 consecutive patients studied by computerized tomography (CT). The following factors did not show significant correlation with brain oedema development: the age and sex of the patient, the occurrence of focal deficits, the presence of skull changes (endostosis, exostosis, osteolysis), the occurrence of tumour calcification, the density of the tumour on plain CT scan, the presence of a cystic component, the pathological subtype of meningioma (both conventional and non-conventional), and the presence of histological features of tumour aggressiveness, such as an increased vascularization, high cellularity, high mitotic index, pleomorphism, necrosis, and brain infiltration. Factors showing a statistically significant correlation with the presence and intensity of brain oedema at the bivariate analysis were: the presence of symptoms (p < 0.001), the duration of the clinical history (p < 0.05), the location and size of the tumour (p < 0.001), the type (heterogeneous vs homogeneous), and intensity of tumour contrast enhancement (p < 0.001), the presence of irregular tumour margins (p < 0.001), and the existence of focal low density intratumoural areas (p < 0.001). The multivariate analysis using only clinical parameters showed that the group of variables with the highest power for predicting the presence of brain oedema (concordance level of 76.8%) included: the presence of symptoms, the occurrence of seizures (focal or generalized), the presence of an intracranial hypertension syndrome, and the age of the patient. The multivariate analysis using only anatomico-radiological parameters showed that the model which included the size of the tumour, the intensity of contrast enhancement, the tumour margins, and meningioma location, predicted the presence of brain oedema in 80.8% of the cases. Though the results of the present study do not definitively support any of the major physiopathological theories proposed to explain brain oedema formation in patients with intracranial meningioma, some findings could favour the so-called hydrodynamic theory.

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Section: Histopathological Factorscontrasting

confidence: 75%

Section: Ct Findings (Skull Changes Tumour Calcification Intensity mentioning

confidence: 46%

Brain oedema in patients with intracranial meningioma

Lobato¹,

Alday²,

Gómez³

et al. 1996

Acta neurochir

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“…7 Vassilouthis and Ambrose included cystic components as one of the CT criteria to assess histological aggressiveness of meningioma. 9 In our series, there were no patients with malignant meningioma but 5 patients (24%) had atypical meningiomas.…”

Section: Discussionmentioning

confidence: 49%

Clinical and histopathological analysis of cystic meningiomas

Jung

Shin

et al. 2005

Journal of Clinical Neuroscience

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“…Meningiomas undergoing necrosis are more often of the meningothelial or angioblastic type and have a slightly higher rate of atypia and postsurgical recurrence. 19 Peritumoral cysts are large, generally unilocular, and contain xanthochromic fluid with high protein content. A peritumoral cyst of Nauta type III may be the outcome of a reactive gliosis or fibroblastic proliferation or the final stage of intense peritumoral edema.…”

Section: Classification and Etiologymentioning

confidence: 99%

Cystic meninigioma

Liu

et al. 2007

Journal of Clinical Neuroscience

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To study the clinical characteristics of cystic meningiomas, we analyzed retrospectively 21 patients with cystic meningiomas and reviewed the literature with regard to clinical presentation, imaging features, preoperative diagnosis, surgical findings, and histopathological results. The cysts were classified into intratumoral and peritumoral cysts based on their relationship to the tumor, and also according to the classification method described by Nauta. For the 21 patients in our group, there were seven peritumoral cysts and 14 intratumoral cysts. Various pathophysiological mechanisms contribute to the formation of cystic meningiomas. The diagnosis of cystic meningiomas based on CT scan can be problematic, and differentiation from glioma or metastasis may be difficult. MRI scans show low signal intensity areas within the mass on T1-weighted images and high signal intensity areas on T2-weighted images, and the solid parts of tumors are contrast-enhanced after gadolinium administration. MRI with gadolinium enhancement dramatically increases the diagnostic accuracy for cystic meningiomas and provides critical information for their surgical care. Total surgical resection of cystic meningioma is ideal, but special attention should be paid to the cyst walls.

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Computerized Tomography Scanning Appearances of Intracranial Meningiomas

Cited by 11 publications

References 0 publications

Brain oedema in patients with intracranial meningioma

Brain oedema in patients with intracranial meningioma

Clinical and histopathological analysis of cystic meningiomas

Cystic meninigioma

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