The Application of MR Brain Surface Anatomy Scanning in the Operation of Intracranial Parasagittal Meningiomas

Abstract

Purpose: To assess the usefulness of magnetic resonance (MR) brain surface anatomy scanning (SAS) in neurosurgery for intracranial parasagittal meningiomas.Methods and Materials: Pre-operative MR brain SAS was performed on 22 patients who underwent operations for intracranial parasagittal meningiomas. The tumour, the sagittal sinus and parasagittal circumflex veins adjacent to the tumour were examined.Results: For all 22 patients, the locations and extensions of brain surface parasagittal circumflex veins observed from MR brain SAS images correlated well with operative findings. Brain surface circumflex veins were preserved completely for 17 patients, in four patients tumour-related brain surface circumflex veins were resected, and in one patient brain surface circumflex veins crossing over the tumour surface were resected. No post-operative oedema or injury in nervous function was found in these patients, hence satisfying surgical outcomes were obtained.Conclusion: MR brain SAS is able to clearly delineate brain surface circumflex veins which are close to parasagittal meningiomas, give an appropriate pre-operative evaluation, and provide instructive suggestions for the preservation or resection of veins on the tumour surface during the operation. It has great significance in the prevention of postoperative vasogenic oedema due to the dysfunction of vein circumfluence and the further neuro-dysfunction due to brain oedema. Consequently the surgical outcome can be improved and post-operative complications can be reduced.