A radio - pathological of dural tail sign of meningiomas

Abstract

Objective To clarify the pathology of the DTS,propose a classification based on the histopathological and radiological correlation.Methods We retrospectively reviewed 179 patients with convexity meningiemas and 89 patients with non- convexity (skull base) meningiomas.The resection range of dura appertained to convexity meningioma was 3 cm from the base of tumor,which corroborated with the lcngth of DTS on MRL Histopatholgical examination of dura at the length of 0.5,1.0,1.5,2.0,2.5 and 3.0 cm from the base of tumor was conducted and the findings correlated with the preoperative MRI appearances of the DTS.Results Tbe DTS was classified into five types:smooth type (37/268,13.8％ ),(48/268,17.9％ ),mixed type(84/268,31.4％ ),symmetrical multipolar type ( 29/268,10.8％ ) and asymmetrical multipolar type (70/268,26.1％ ).Tunor invasion was found in 88.3％ (158/179) of the Simpson grade I specimens.Of this,the range of invasion in 82.3％ ( 130/1 58 ) was within 2cm and that in 94.9％ ( 150/158 ) was within 2.5 cm.The incidence of invasion and the range invaded by tumor cells varied in different types of DTS, and significant differences were found after statistical analysis ( P=0.000).Conclusions The range of dural resection for convexity meningiomas should be 2.5 cm from the tumor base,and the type of DTS be sought for if this extent of resection is not feasible.Even so,for meningiomas from skull base,where Simpson Grade I1 is employed,attempts should be focused on resecting the dura based on the type of DTS on MRI that depicts tumor invasion.The classification of DTS enables the surgeon to preoperatively predict and achieve the optimum range of dural resection that would successfully reduce the recurrence rate of meningiomas. Key words: Meningiomas; Dural tail sign (DTS); Pathology; MRI; Classification