Clinical Research Of CE-MRV In The Preoperative Evalution Of Parasagittal Sinus Meningioma

Objective To investigated the assessment results of CE-MEV when preoperative evalute parasagittal meningioma patients in the following respects:①Place where tumors encroachment the sagittal sinus ②Degree of occlusion of the sagittal sinus③Situation of collateral venous circulation.Method Choose 26 patients who diagnosed with parasagittal meningioma in department of neurosurgery,Ningxia Medical University General Hospital.Every patient reserve CE-MRV preoperatively,collect their clinical and radiological data,and contrast with surgical results in the following respects:①Place where tumors encroachment the sagittal sinus ②Degree of occlusion of the sagittal sinus③Situation of collateral venous circulation.With intraoperative findings as the gold standard,we can find out the assessment effect of CE-MEV in preoperative evaluting parasagittal meningioma patients.Results According to Simpson resection of meningioma grading standard, 26 cases of resection grade Ⅰ was 9 cases(35%), grade II was 13 patients( 50%),grade III resection in 3 cases( 11%), IV in 4 cases( 4%), there was no grade Ⅴ excision and death case. All cases were treated by microneurosurgery. In the operation procedure,compared with the preoperative CE-MRV assessment, in cases meningioma have relations with sagittal sinus but no change in the sagittal sinus, and cases shows varying degrees of sagittal sinus compression, sinus narrowing but not completely occluded,there are no obvious discrepancy in intraoperation procedure.In cases the mengningiomas invaded venous sinus, sagittal sinus occlusion, sinus filling defect, compensatory collateral circulation take shap, one case has confirmed preopreation, but confirmed intraoperation that sagittal sinus is patency.We calculated the sensitivity of preoperative CE-MRV assessment is 100% and specificity is 95.65%, accuracy is 96.15% There are 5 cases have intracranial infectiontransient postoperative, and completely cured after active anti-infection treatment,limb dysfunction in 3 cases,symptoms were relieved after active therapy.All casas were score with GOS before discharge,22 patients prognosis is good,3 patients is mild disability,1 case is severe disability.Conclusion 1 、 CE-MRV can pefectly preoperative evaluate parasagittal sinus meningioma in respects of finding out the place tumors encroachment the sagittal sinus and assess the degree of occlusion of the sagittal sinus and tell the situation of collateral venous circulation.2、The specificity of preoperative CE-MRV assessment is slightly less,and there may be a false positive.So,to cases that CE-MRV preoperative examinations showed complete occlusion of the sagittal sinus but inadequate venous collateral circulation,we should confirm that intraoperative.3、We should pay attention to protect the superior sagittal sinus and normal anatom structure.To the sinus tumor which can not be resected entirely,we should weigh pros and cons,choose to reconstruct sagittal sinus or postoperative adjuvant therapy.