OBJECTIVE: The preoperative radiological findings of computed tomographic and magnetic resonance imaging scans of 70 patients with petroclival meningioma were evaluated and statistically compared with the degree of surgical resection and patients' outcomes to depict the most important radiological findings that may influence surgical radicality and outcome. METHODS: The following parameters were evaluated: 1) tumor diameters; 2) tumor extension toward the middle fossa, the internal auditory canal, the brainstem, and the foramen magnum; 3) bone changes; 4) peritumoral edema; 5) signs of tumor infiltrative pattern; and 6) surgical radicality. Postoperative results were analyzed immediately after the surgery and in a long-term follow-up study. RESULTS: Larger tumors affected a younger population and presented a significantly shorter time until symptom onset. In the majority of cases (67%), the tumor extended to the parasellar region. Tumor extension toward the jugular foramen was found in 24% of the patients and reached the level of the foramen magnum in 18%. Irregular tumor margins were found in 67% of the tumors, and 50% of them presented peritumoral edema in addition. Interestingly, edema also was found in 20% of tumors with well-delineated margins. CONCLUSION: Tumor size, brainstem compression, and tumor extension laterally to the internal auditory canal did not influence either the degree of surgical resection or the long-term outcome (P > 0.05). Supratentorial tumor extension to the middle fossa and downward involving the caudal cranial nerves displayed a significant importance in regard to the surgical radicality and the patient's outcome, respectively (P < 0.05). Radiological evidence of infiltrative tumor pattern and peritumoral edema at the brainstem surface were important parameters regarding surgical radicality (P < 0.05). However, only peritumoral edema influenced the long-term results significantly.
OBJECTIVE: The preoperative radiological findings of computed tomographic and magnetic resonance imaging scans of 70 patients with petroclival meningioma were evaluated and statistically compared with the degree of surgical resection and patients' outcomes to depict the most important radiological findings that may influence surgical radicality and outcome. METHODS: The following parameters were evaluated: 1) tumor diameters; 2) tumor extension toward the middle fossa, the internal auditory canal, the brainstem, and the foramen magnum; 3) bone changes; 4) peritumoral edema; 5) signs of tumor infiltrative pattern; and 6) surgical radicality. Postoperative results were analyzed immediately after the surgery and in a long-term follow-up study. RESULTS: Larger tumors affected a younger population and presented a significantly shorter time until symptom onset. In the majority of cases (67%), the tumor extended to the parasellar region. Tumor extension toward the jugular foramen was found in 24% of the patients and reached the level of the foramen magnum in 18%. Irregular tumor margins were found in 67% of the tumors, and 50% of them presented peritumoral edema in addition. Interestingly, edema also was found in 20% of tumors with well-delineated margins. CONCLUSION:Tumor size, brainstem compression, and tumor extension laterally to the internal auditory canal did not influence either the degree of surgical resection or the long-term outcome (P > 0.05). Supratentorial tumor extension to the middle fossa and downward involving the caudal cranial nerves displayed a significant importance in regard to the surgical radicality and the patient's outcome, respectively (P < 0.05). Radiological evidence of infiltrative tumor pattern and peritumoral edema at the brainstem surface were important parameters regarding surgical radicality (P < 0.05). However, only peritumoral edema influenced the long-term results significantly.
Authors: Jarnail Bal; Michael Bruneau; Moncef Berhouma; Jan F Cornelius; Luigi M Cavallo; Roy T Daniel; Sebastien Froelich; Emmanuel Jouanneau; Torstein R Meling; Mahmoud Messerer; Pierre-Hugues Roche; Henry Schroeder; Marcos Tatagiba; Idoya Zazpe; Dimitrios Paraskevopoulos Journal: Acta Neurochir (Wien) Date: 2021-12-02 Impact factor: 2.216
Authors: Robert Starke; Hideyuki Kano; Dale Ding; Peter Nakaji; Gene H Barnett; David Mathieu; Veronica Chiang; James B Yu; Judith Hess; Heyoung L McBride; Norissa Honea; John Y K Lee; Gazanfar Rahmathulla; Wendi A Evanoff; Michelle Alonso-Basanta; L Dade Lunsford; Jason P Sheehan Journal: J Neurooncol Date: 2014-05-13 Impact factor: 4.130