Extent of T1+C Intensity Is a Predictor of Blood Loss in Resection of Meningioma.

Abstract

Surgery for meningioma is associated with significant blood loss. Preoperative embolization has been associated with reduction of blood loss and has been noted to decrease intensity on T1+ contrast sequences. We investigate potential relationships between blood loss and the extent of T1+ contrast intensity. Forty-two patients who underwent surgical resection of intracranial meningioma were retrospectively reviewed from August 2009 to May 2016. Clinical data were extracted (age, gender, location of meningioma, grade of meningioma, need for blood transfusion during surgery, preoperative and postoperative hematocrit level, estimated blood loss [EBL], and duration of surgery). Using OsiriX MD, the tumor volume, sinus involvement, peritumoral edema, extent of resection, and T1 index (average T1+C intensity across the tumor normalized to value at basilar artery) were assessed. With EBL, univariate analysis for gender, tumor volume, and T1 index showed correlations with Pvalue <0.1. A logistic regression to predict EBL <300 mL and ≥300 mL using the 3 variables yielded T1 index (odds ratio [OR], 31.22; 95% confidence interval [CI], 1.14-855.65), gender (OR, 0.17; 95% CI, 0.03-0.96), and tumor volume (OR,1.05; 95% CI, 1.00-1.10) as significant predictors (all P< 0.05). With duration for surgery, gender, tumor volume, need for blood transfusion, and preoperative hematocrit exhibited P value <0.05; multivariate analysis did not show a significant model. Along with gender and tumor volume, extent of T1+C intensity is also an independent predictor of EBL. This finding may be helpful for surgical management of meningioma.