Appliance of 3D-CT venography for the preoperative evaluation of parasagittal meningioma

Abstract

Objective The authors investigated applying of3D-CTvenography (3D-CTV) to identify the superior sagittal sinus and parietal vein of Rolando for the preoperative surgerical plan for parasagittal and falx meningiomas. Methods A series of 11 consecutive patients with parasagittal and falx meningiomas were surgically treated in our department from June 2008 to February 2010. All patients underwent 3D-CTV preoperative to explore the involved superior saggitial sinus and important cortical drainage vein before operation.Result According to Simpson's scale, 9 procedures were Grade Ⅰ resection, 2 were Grade Ⅱ resection. The postoperative course was tncomplicated and all the patinets had satisfactory outcome on discharge. Among 11 patients with parasagittal meningiomas invading the sagittal sinus, 3D-CTV demonstrated the sagittal sinus were completely obstructed in 4 cases preoperative, which the radical resection of the tumor including the invaded part of sinus was made; 4 cases with meningiomas partial invading the sagittal sinus and the sintus still unobstructed demonstrated by 3D-CTV, which the radical resection of the tumor including the invaded wall of sinus was made and the sagittal sinus was reconstructed in 3 cases; 3 cases with meningiomas invading the lateral wall of the sagittal sinus demonstrated by 3D-CTV, which the resection of the tumor including the outer layer of the lateral wall of sinus was made in 1 case. There were no tumor recurrence at the last follow-up.Conclusions Comparing with MRV and DSA, 3D-CTV can examine the parasagittal meningiomas including the involved sagittal sinus and cortical drainage vein more easily and exactly, and it should be performed and scrutinized carefully before planning the surgical treatment for the parasagittal meningiomas. Key words: 3D-CT venography; Meningoma; Sagittal sinus