The relationship of superficial cerebral veins with meningiomas by simulation craniotomy techuique

Abstract

Objective To assess the value of simulation craniotomy (SC) technique in evaluation of superficial cerebral veins (SCVs) and its relationship with convexity,parasagittal and falcine meningiomas.Methods Forty-nine consecutive patients with convexity,parasagittal,and falcine meningiomas performed SC technique and three-dimensional contrast enhanced MR venography (3D CE MRV) in a prospective study.The number of SCVs ( diameter ＞ 1 mm) within 2 cm around the margin of tumors detected by two techniques were compared with the paired t test.Furthermore,49 cases were divided into groups according to the tumor largest diameter,position,and dural enhancement.The image quality of SC technique in different groups were analyzed by Wilcoxon test in order to find influence factors.Results The number of SCVs within 2 cm around the margin of tumor in SC was 4.4 ± 1.9,which was significantly less than that on 3D CE MRV (5.1 ± 2.7) ( t =3.131,P ＜ 0.05 ).The relationship between meningiomas and the SCVs was demonstrated well on SC in majority of cases with the score of image quality was 2.5 ±0.7.The score of image quality of 12 patients with obvious dural enhancement was 1.5 ± 0.5,which was significantly lower than that of 37 patients without dural enhancement ( 2.8 ± 0.3 ) ( Z =- 3.093,P ＜ 0.05 ).The score of image quality of 18 patients with tumor larger than 4 cm in diameter ( 2.2 ± 0.9 )was significantly lowed than that of 31 patients with small tumors (2.7 ± 0.5 ) ( Z =- 2.057,P ＜ 0.05 ).The score of image quality of convexity group ( n =10) and parasagittal and falcine group ( n =39 ) was 2.2 ± 0.9 and 2.6 ± 0.6,and there was no significant difference between different location group ( Z =- 0.604,P ＞ 0.05).Conclusions Simulation craniotomy can exactly display SCVs avoiding the influence of deep cerebral veins and skull veins.This simple technique can provide useful information about the SCVs and their relationships with cortical structures and tumors for preoperative surgical planning. Key words: Meningioma; Cerebral veins; Magnetic resonance imaging