Angiomatous Meningiomas Have a Very Benign Outcome Despite Frequent Peritumoral Edema at Onset
Angiomatous Meningiomas Have a Very Benign Outcome Despite Frequent Peritumoral Edema at Onset
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尽管发病时经常出现瘤周水肿，但血管瘤性脑膜瘤的预后非常良性
DOI：
10.1016/j.wneu.2017.08.096
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发表时间：
2017-12-01
影响因子：
2
通讯作者：
Gong, Ye
中科院分区：
文献类型：
--
作者：
Hua, Lingyang;Luan, Shihai;Gong, Ye
目的：血管性脑膜瘤（AM）是一种罕见的脑膜瘤亚型，其特征是高度血管化的肿瘤组织，主要由大小不一的透明变性血管组成。本研究旨在评估单个神经外科中心中AM的临床影像学特征及长期预后。
方法：纳入2003年至2008年间接受AM手术切除的93例患者进行分析。收集并分析临床信息、治疗情况和影像学图像，同时进行随访。通过免疫组织化学分析雌激素受体、孕激素受体和血管内皮生长因子的表达。
结果：确定有48名女性和45名男性。44例患者（47.31%）在T1加权成像序列中表现为高信号，68例（73.12%）在T2加权成像中表现为高信号，28例患者（30.11%）观察到特征性的环形信号。81例（87.10%）显示不同程度的瘤周脑水肿，且与血管内皮生长因子表达显著相关（P < 0.001）。63例患者（67.74%）实现辛普森I级切除，27例患者（29.03%）为II级，3例患者（3.23%）为III级。切除范围与术后神经功能无关（P = 0.546）。在随访期间仅有4例患者复发，且这4例患者在最后一次随访时病情稳定。
结论：AM是一种具有独特影像学特征的特殊脑膜瘤亚型。AM表现为良性行为，预后良好，这使得辛普森II级切除成为一种选择。
OBJECTIVE: Angiomatous meningioma (AM) is a rare subtype of meningioma characterized by highly vascular tumor tissue comprising predominantly variable sized hyalinized blood vessels. The aim of this study is to evaluate the clinical radiologic features of AM and the long-term prognosis in a single neurosurgical center.METHODS: A total of 93 patients who underwent surgical resection of AMs between 2003 and 2008 were enrolled for analysis. Clinical information, treatment, and radiologic images were collected and analyzed; follow-up was carried out as well. Expression of estrogen receptor, progesterone receptor, and vascular endothelial growth factor was analyzed by immunohistochemistry.RESULTS: Forty-eight females and 45 males were identified. Forty-four patients (47.31%) manifested as hypersignal in T1-weighted imaging sequences and 68 (73.12%) as hypersignal in T2-weighted imaging, and a characteristic ringlike signal was observed in 28 patients (30.11%). Eighty-one cases (87.10%) showed different degrees of peritumor brain edema and it was significantly correlated with the vascular endothelial growth factor expression (P < 0.001). Simpson I resection was achieved in 63 patients (67.74%), grade II in 27 patients (29.03%), and grade III in 3 patients (3.23%). The extent of resection was not associated with the postoperative neurologic function (P = 0.546). Only 4 patients experienced recurrences during the follow-up and these 4 patients were stable until the last follow-up.CONCLUSIONS: AMs were a special subtype of meningioma with distinctive radiologic features. AMs manifest benign behavior with a satisfying outcome, which makes Simpson grade II resection an option.