Location and Diameter of Intracranial Meningioma as Predictors of Peritumoral Brain Oedema and Mass Effect

J Med Imaging Radiat Sci. 2020 Sep;51(3):411-416. doi: 10.1016/j.jmir.2020.04.004. Epub 2020 May 15.

Abstract

Introduction: The presence of peritumoral oedema or mass effect with intracranial meningiomas is associated with poor clinical outcomes. This study aimed to investigate magnetic resonance (MR) morphologic features of meningioma, which can predict peritumoral oedema and mass effect.

Methods: Data of 100 consecutive patients diagnosed with meningioma on MRI brain at the neurosurgical MRI unit, National Hospital of Sri Lanka, reported by a Consultant Radiologist were analysed in a retrospective study. Binary logistic regression models were fitted to identify predictors of perilesional oedema and mass effect.

Results: Female-to-male ratio was 5.8:1. Patients were aged 18-80 years. Majority (n = 78) were in supratentorial compartment with 16 at parasagittal location. Cerebellopontine angle was the commonest infratentorial site (n = 9). Size of meningiomas ranged from 1.1 to 9.1 cm (largest dimension). Mass effect (n = 68), perilesional oedema (n = 37), and midline deviation (n = 31) were the most commonly reported complications. Maximum diameter of meningioma and its location significantly predicted the presence of perilesional oedema [χ2(2,47) = 6.03, P = .049, Nagelkerke R2 = 18.2%] and mass effect [χ2(2,71) = 16.73, P = .000, Nagelkerke R2 = 39.4%] in two logistic regression models.

Conclusion: The probability of mass effect and perilesional oedema increased with the maximum diameter. Meningioma extending to both supratentorial and infratentorial compartments had the highest risk of having concomitant perilesional oedema and mass effect.

Keywords: Neuroimaging; brain neoplasms; complications; magnetic resonance imaging.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Edema / etiology*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Meningeal Neoplasms / complications*
  • Meningeal Neoplasms / diagnostic imaging*
  • Meningeal Neoplasms / pathology
  • Meningioma / complications*
  • Meningioma / diagnostic imaging*
  • Meningioma / pathology
  • Middle Aged
  • Neuroimaging
  • Prognosis
  • Retrospective Studies
  • Tumor Burden
  • Young Adult