Evaluation of Surgical Cleavage Plane by Preoperative Magnetic Resonance Imaging Findings in Adult Intracranial Meningiomas

Abstract

(1) Background: Meningiomas are usually benign encapsulated intracranial tumors with well-defined borders that offer a high chance of cure with complete removal. The aim of this study was to evaluate the association between preoperative MRI features and surgical plane of cleavage. (2) Materials and Methods: This was a cross-sectional observational study conducted in the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University. Data were recorded from 48 study participants with confirmed intracranial meningioma and analyzed by IBM SPSS (version 23). (3) Results: The highest incidence of intracranial meningioma was observed in the third decade of life of our study participants. The female to male ratio was 1.82:1. The most common location of meningiomas was convexity (29.16%), sphenoid wing (22.91%), parasagittal (20.83%), and falcine (14.58%). Most of the patients (68.8%) had medium-sized tumors, and 75.0% exhibited hyperintense signal change in the tumor parenchyma on T2-weighted imaging. One-third (33.3%) of patients were characterized as no edema, focal edema, and lobar/hemispheric edema. There was no statistically significant association between tumor size and types of surgical cleavage plane. Different signal intensities of tumor parenchyma, as well as types of peritumoral edema, showed no statistically significant association with surgical cleavage plane (p > 0.05). (4) Conclusion: There was no association among the size of the tumor, extent of peritumoral edema, the intensity of the tumor on T2-weighted images, and the types of surgical cleavage plane. Future studies with larger sample sizes are required to find out more precise findings.

Cystic meningiomas: A complex diagnostic challenge and clinicopathological insights from a unique case presentation

“…They demand careful consideration to avoid misdiagnosis and ensure appropriate treatment. Although meningiomas are more commonly found in females, the occurrence of the cystic type is more prevalent in males and children, presenting an intriguing aspect of gender‐based variation in manifestation 7–11 …”

Acute disseminated encephalomyelitis and viral encephalitis: An unusual and misleading imaging

“…Hence it was not acute hemorrhagic leukoencephalitis (AHL). AHL, AHEM, and acute necrotizing hemorrhagic leukoencephalitis (ANHLE) of Weston Hurst are different variants of acute, rapidly progressive, and frequently fulminant inflammatory hemorrhagic demyelination of CNS white matter 8–14 . Death from brain edema is common within 1 week of onset of encephalopathy.…”

“…AHL, AHEM, and acute necrotizing hemorrhagic leukoencephalitis (ANHLE) of Weston Hurst are different variants of acute, rapidly progressive, and frequently fulminant inflammatory hemorrhagic demyelination of CNS white matter. [8][9][10][11][12][13][14] Death from brain edema is common within 1 week of onset of encephalopathy. There can be favorable outcomes with early and aggressive treatment with combination of corticosteroids, immunoglobulins, cyclophosphamide, and therapeutic plasma exchange.…”

The Role of [68Ga]Ga-DOTA-SSTR PET Radiotracers in Brain Tumors: A Systematic Review of the Literature and Ongoing Clinical Trials

“…Since the study by Henze et al [ 11 ] in 2001, [ 68 Ga]Ga-DOTA-SSTR PET studies have expanded beyond neuroendocrine neoplasms in neuro-oncology, primarily for meningiomas, with the goal to improve tumor detection, differentiation, and extent-of-infiltration. While most meningiomas are easily identifiable at standard MRIs by showing typical pathognomonic features, lesions with intraosseous extensions, invading the skull base, or adjacent to the falx cerebri, may pose some diagnostic challenges [ 63 , 93 , 94 , 95 ]. By selectively binding to SSTR, [ 68 Ga]Ga-DOTA-SSTR radiotracers allow for targeted uptake by SSTR-positive neoplasms and high tumor-to-background contrast, offering higher accuracy in evaluating the infracranial/transosseous extent of meningiomas infiltration and detection of synchronous lesions undetected by MRI studies [ 31 , 34 ].…”