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

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, ha...

Full description

Bibliographic Details
Main Authors: Kosei Ono, Takayoshi Shimizu, Shunsuke Fujibayashi, Bungo Otsuki, Koichi Murata, Akio Sakamoto, Shuichi Matsuda
Format: Article
Language:English
Published: Korean Spinal Neurosurgery Society 2021-03-01
Series:Neurospine
Subjects:
Online Access:http://www.e-neurospine.org/upload/pdf/ns-2040494-247.pdf
_version_ 1797335401043591168
author Kosei Ono
Takayoshi Shimizu
Shunsuke Fujibayashi
Bungo Otsuki
Koichi Murata
Akio Sakamoto
Shuichi Matsuda
author_facet Kosei Ono
Takayoshi Shimizu
Shunsuke Fujibayashi
Bungo Otsuki
Koichi Murata
Akio Sakamoto
Shuichi Matsuda
author_sort Kosei Ono
collection DOAJ
description 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.
first_indexed 2024-03-08T08:36:39Z
format Article
id doaj.art-b4fdbdbbe5ea4b7b8a37ec8b016477a0
institution Directory Open Access Journal
issn 2586-6583
2586-6591
language English
last_indexed 2024-03-08T08:36:39Z
publishDate 2021-03-01
publisher Korean Spinal Neurosurgery Society
record_format Article
series Neurospine
spelling doaj.art-b4fdbdbbe5ea4b7b8a37ec8b016477a02024-02-02T01:03:22ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912021-03-0118116316910.14245/ns.2040494.2471082Predictive Value of Heterogeneously Enhanced Magnetic Resonance Imaging Findings With Computed Tomography Evidence of Calcification for Severe Motor Deficits in Spinal MeningiomaKosei Ono0Takayoshi Shimizu1Shunsuke Fujibayashi2Bungo Otsuki3Koichi Murata4Akio Sakamoto5Shuichi Matsuda6 Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto, JapanObjective 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.http://www.e-neurospine.org/upload/pdf/ns-2040494-247.pdfspinal meningiomacomputed tomographymagnetic resonance imagingcalcificationmotor deficit
spellingShingle Kosei Ono
Takayoshi Shimizu
Shunsuke Fujibayashi
Bungo Otsuki
Koichi Murata
Akio Sakamoto
Shuichi Matsuda
Predictive Value of Heterogeneously Enhanced Magnetic Resonance Imaging Findings With Computed Tomography Evidence of Calcification for Severe Motor Deficits in Spinal Meningioma
Neurospine
spinal meningioma
computed tomography
magnetic resonance imaging
calcification
motor deficit
title Predictive Value of Heterogeneously Enhanced Magnetic Resonance Imaging Findings With Computed Tomography Evidence of Calcification for Severe Motor Deficits in Spinal Meningioma
title_full Predictive Value of Heterogeneously Enhanced Magnetic Resonance Imaging Findings With Computed Tomography Evidence of Calcification for Severe Motor Deficits in Spinal Meningioma
title_fullStr Predictive Value of Heterogeneously Enhanced Magnetic Resonance Imaging Findings With Computed Tomography Evidence of Calcification for Severe Motor Deficits in Spinal Meningioma
title_full_unstemmed Predictive Value of Heterogeneously Enhanced Magnetic Resonance Imaging Findings With Computed Tomography Evidence of Calcification for Severe Motor Deficits in Spinal Meningioma
title_short Predictive Value of Heterogeneously Enhanced Magnetic Resonance Imaging Findings With Computed Tomography Evidence of Calcification for Severe Motor Deficits in Spinal Meningioma
title_sort predictive value of heterogeneously enhanced magnetic resonance imaging findings with computed tomography evidence of calcification for severe motor deficits in spinal meningioma
topic spinal meningioma
computed tomography
magnetic resonance imaging
calcification
motor deficit
url http://www.e-neurospine.org/upload/pdf/ns-2040494-247.pdf
work_keys_str_mv AT koseiono predictivevalueofheterogeneouslyenhancedmagneticresonanceimagingfindingswithcomputedtomographyevidenceofcalcificationforseveremotordeficitsinspinalmeningioma
AT takayoshishimizu predictivevalueofheterogeneouslyenhancedmagneticresonanceimagingfindingswithcomputedtomographyevidenceofcalcificationforseveremotordeficitsinspinalmeningioma
AT shunsukefujibayashi predictivevalueofheterogeneouslyenhancedmagneticresonanceimagingfindingswithcomputedtomographyevidenceofcalcificationforseveremotordeficitsinspinalmeningioma
AT bungootsuki predictivevalueofheterogeneouslyenhancedmagneticresonanceimagingfindingswithcomputedtomographyevidenceofcalcificationforseveremotordeficitsinspinalmeningioma
AT koichimurata predictivevalueofheterogeneouslyenhancedmagneticresonanceimagingfindingswithcomputedtomographyevidenceofcalcificationforseveremotordeficitsinspinalmeningioma
AT akiosakamoto predictivevalueofheterogeneouslyenhancedmagneticresonanceimagingfindingswithcomputedtomographyevidenceofcalcificationforseveremotordeficitsinspinalmeningioma
AT shuichimatsuda predictivevalueofheterogeneouslyenhancedmagneticresonanceimagingfindingswithcomputedtomographyevidenceofcalcificationforseveremotordeficitsinspinalmeningioma