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Biplane computed tomography of intracranial meningiomas with extracranial extension
Abstract:
Fifteen of 130 intracranial meningiomas evaluated by biplane computed tomography (CT)--axial transverse and coronal--were found to have direct extracranial extension. These include five pterional meningiomas en plaque with extension to the orbit and temporal fossa; three subfrontal meningiomas invading the paranasal sinuses, nasal cavity, or orbit; three posterior fossa meningiomas with extracranial extension to the neck; three hyperostosing parasagittal meningiomas with extracranial tumors; and one tuberculum sellae meningioma with spread to the optic sheath. Biplane CT is of value in delineating the precise extent of the tumor, both intracranially and extracranially, as well as in evaluating bony changes such as hyperostosis or destruction.
Insights
Biplane computed tomography (CT) identified extracranial extension in 15% of intracranial meningiomas. This imaging technique precisely maps tumor extent and associated bone changes, aiding surgical planning.
Area of Science:
- Neurosurgery
- Radiology
- Oncology
Background:
- Intracranial meningiomas are common primary tumors of the central nervous system.
- Assessing the full extent of meningiomas, including extracranial invasion, is crucial for effective treatment planning.
Observation:
- Biplane computed tomography (CT), utilizing both axial transverse and coronal views, was employed to evaluate 130 intracranial meningiomas.
- Direct extracranial extension was identified in 15 (11.5%) of the evaluated meningiomas.
Findings:
- Specific locations of extracranial extension included pterional (n=5), subfrontal (n=3), posterior fossa (n=3), hyperostosing parasagittal (n=3), and tuberculum sellae (n=1) meningiomas.
- Extension patterns involved the orbit, temporal fossa, paranasal sinuses, nasal cavity, neck, and optic sheath.
- Biplane CT effectively delineated both intracranial and extracranial tumor margins, as well as bony alterations like hyperostosis and destruction.
Implications:
- Biplane CT provides comprehensive anatomical information for meningiomas with extracranial extension.
- Accurate delineation of tumor extent by biplane CT is vital for surgical resection and management strategies.
- This imaging modality aids in evaluating secondary bony changes, which can impact surgical approach and prognosis.