Study of parasagittal meningiomas invading venous sinuses with 3D-CEMRV
ZHA Yun-fei1, KONG Xiang-quan2, YANG Jian-yong1, LIU Ding-xi2, FENG Gan-sheng2
1. Department of Radiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China; 2. Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
Abstract：Objective: To evaluate visualization of sites, degree of invasion, tumor-related veins and collateral venous pathways with three dimensional contrast enhanced magnetic resonance venography(3D-CEMRV) in parasagittal meningiomas invading the dural sinuses. Methods: Ten patients with parasagittal meningiomas were examined preoperatively with 3D-CEMRV and intraarterial digital subtraction angiography(DSA). The visualization of sites, degree, tumor-related veins and collateral venous pathways in meningiomas invading the dural sinuses were recorded in consensus by two radiologists. Compared with DSA and intraoperative findings, all manifestations were assessed on source images, maximum intensity projection images(MIP) and multiplanar reconstruction images(MPR). Results: Of the 10 patients with parasagittal meningiomas, 1 appeared invasion of sinus wall, 2 partial occlusion of sinus lumina, 7 complete occlusion of sinus lumina. The visualization of the sites of 10 parasagittal meningiomas invading the dural sinuses on 3D-CEMRV was in accordance with that of DSA and intraoperative findings. For the visualization of the degree of invasion, 3D-CEMRV images were found to be equivalent to DSA images(u=0.0000, P=1.0000), in the meanwhile, MIP images combined with MPR images and source images were superior to single MIP images(u=-1.8796, P=0.0301). With multiple postprocessing display modalities of 3D-CEMRV and DSA, the rate of the visualization of tumor-related veins and collateral venous pathways was 78.26%(36/46) and 97.83%(45/46) respectively(P=0.0016). Conclusion: With 3D-CEMRV, an exact preoperative evaluation of the sites and degree of invasion in parasagittal meningiomas invading the dural sinuses are feasible. Nevertheless, for the total visualization of tumor-related veins and collateral venous pathways, 3D-CEMRV is still inferior to DSA.
2007, Vol. 18 
