Trigone ventricular meningioma
Thirty patients with trigone meningiomas were enrolled in this retrospective study. Conventional MRI was performed in all patients; SWI (17 cases), dynamic contrast-enhanced PWI (10 cases), and dynamic susceptibility contrast PWI (6 cases) were performed. Demographics, conventional MRI features, SWI- and PWI-derived parameters were compared between different grades of trigone meningiomas.
On conventional MRI, the irregularity of tumor shape (ρ = 0.497, P = 0.005) and the extent of peritumoral edema (ρ = 0.187, P = 0.022) might help distinguish low-grade and high-grade trigone meningiomas. On multiparametric functional MRI, rTTPmax (1.17 ± 0.06 vs 1.30 ± 0.05, P = 0.048), Kep, Ve, and iAUC demonstrated their potentiality to predict World Health Organization grades I, II, and III trigone meningiomas.
Conventional MRI combined with dynamic susceptibility contrast and dynamic contrast-enhanced can help predict the World Health Organization grade of trigone meningiomas 1).
Trigone Meningioma General University Hospital of Alicante Cases
A 65-year-old female refers to a speech disorder (slowed speech and stuttering) for months of evolution, the reason for which an MRI study was performed. Refers to impaired reading (blurred vision of some letters) associated.
In the left hemisphere, a rounded tumor of 28 mm in greater diameter is located inside the lateral ventricle. It is a tumor slightly hypointense on T1, slightly hyperintense on Flair, and practically isointense on T2. The lesion uptakes contrast intense and relatively uniform way. The posterior horn of the ventricle appears dilated and there is a modification of the signal intensity of the adjacent tissue. However, the midline does not appear displaced. the ventricle right lateral and third ventricles are dilated
General anesthesia. Right lateral decubitus position with Mayfield skull clamp. Incision and craniotomy location with craniometric points (intraparietal point). Left parietal craniotomy with the high-speed motor. U-shaped dural opening with a sagittal sinus base. The postcentral sulcus and intraparietal sulcus are visualized in the cortex. Location of the atrium and tumor with intraoperative ultrasound. Approach through the intraparietal sulcus in its lower portion until the ventricle was opened and a pinkish-colored tumor with a rubbery consistency visible, macroscopically compatible with meningioma. Dissection of the edges at the intraventricular level, separating the choroid plexus and coagulating and sectioning several nutrient arteries. Tumor dissection with CUSA until leaving a small fragment that is dissected from the medial wall of the ventricle and excised. Macroscopically complete resection. Careful hemostasis and abundant washing. Dural closure is almost hermetic and sealed with Tachosil. Bone replacement with titanium trephine plates and plugs. Cutaneous closure by planes. Stapled skin. The sample is sent to pathology.