Multi-phase CT Angiography in Preoperative Evaluation of Skull Base Meningioma / 中国医学影像学杂志

ABSTRACT

Purpose The operating skull base meningioma is difficult,and the blood vessel related complications are extremely dangerous.This paper aims to investigate the value of multi-phase CT angiography in preoperative evaluation of skull base meningioma,hoping to improve the operation safety.Materials and Methods The data of a total of 46 patients with pathologically confirmed skull base meningioma in the First Affiliated Hospital of Bengbu Medical College from January 2015 to December 2016 were retrospectively analyzed.Preoperative multi-phase CT angiography was performed on all patients.Post-processing techniques were used to observe the relationship between the supply artery of the tumor,the tumor body and the adjacent vessels,including multi-plane reformation,volume rendering and multi-phase image fusion,the observed results were compared with the intraoperative findings,and the consistency between preoperative angiographic results and intraoperative findings was evaluated.Results Among the CT angiography data of these 46 patients,44 cases could clearly display the supply artery of the tumor,including 15 cases of simple external carotid artery,13 cases of mixed internal and external carotid artery,16 cases of simple internal carotid artery and 2 unclear cases.Compared with the intraoperative findings,the coincident rate was 84.78％,with a favorable consistency (Kappa=0.78).Among the 46 patients,36 cases had no invasion in blood vessels and 10 cases had vascular invasion.The coincident rate between the results of multi-phase CT angiography and intraoperative findings reached 95.65％,and the consistency was favorable (Kappa=0.93);the coincident rate between the results of arterial phase CT angiography and intraoperative findings was 67.39％,and the consistency was ordinary (Kappa=0.45).Conclusion Multi-phase CT angiography can clearly display the feeding artery of skull base meningioma and its relationship with adjacent vessels,and it is of great significance for the preoperative evaluation of surgical risk,the formulation of surgery program and the improvement of surgical safety.