Baran YİLMAZ, Süleyman SENER, Hasanaov TEYYUB, Akın AKAKIN, Özlem YAPICIER, Mustafa Kemal DEMİR

Görsel kalitatif DW görüntüleme, ADC kantifikasyonu ve Ki-67 proliferasyon indeksinin referans

Amaç: Bu çalışmada amacımız, intrakranyal meningiomların derecelendirmesinde görsel kalitatif DW görüntüleme, ADC kantifikasyonu ve Ki-67 proliferasyon indeksinin referans standart histopatoloji ile karşılaştırıldığında etkinliğini araştırmaktır. Gereç ve Yöntem: Patolojisi meningiom olarak rapor edilmiş toplam 35 hastamızın, konvansiyonel MR görüntülemeleri, kontrastlı MR görüntülemeleri, DW görüntülemeleri ve ADC haritaları arşivimizden elde edilmiştir. Bulgular: Sekiz hastada (23%) atipik (5 kadın ve 3 erkek; ortalama yaş: 57.1±15.8 yıl); 27 hastada ise (77%) düşük dereceli tipik meningiom (19 kadın, 8 erkek; ortalama yaş: 54.3±14.0 yıl) vardı. Hem (59%) en sık histolojik alttip meningotelyal tip idi. Ki-67 proliferasyon indeksi, düşük dereceli ve atipik meningiomlarda sırasıyla 2.31±1.44% (aralık: 1-5) and 7.37 ± 2.72% (aralık: 3-10) olarak saptandı. Görsel kalitatif değerlendirmede, difüzyon kısıtlanması atipi meningiomlarda daha belirgindi (p<0.05). Kantitatif değerlendirmede, ADC değerlerinde heriki grup arasında anlamlı fark saptanmadı (p=0.471). Sonuç : Görsel kalitatif DW görüntüleme değerlendirmesinin, atipi ve cerrahi tedavi uygulanmış meningiom hastalarında tekrarlama riskinin tahmininde yardımcı olabileceğini önermekteyiz.

Anahtar Kelimeler:

difüzyon ağırlıklı görüntüleme, meningiom, cerrahi, histopatoloji

Visual qualitative evaluation of diffusion-weighted imaging, apparent diffusion coefficient quantification and Ki-67 proliferation index for predicting atypia in surgical meningiomas

Object. The goal in this study was to investigate the efficiency of qualitative evaluation using DW imaging, ADC quantification, and Ki-67 proliferation labeling index in grading intracranial meningiomas compared to our reference standard histopathology.Methods. From our database, we enrolled 35 consecutive patients with pathologic report of a meningioma, conventional MR imaging, contrast-enhanced MR imaging, DW imaging and ADC maps.Results. Eight patients (23%) had atypical meningioma (5 women and 3 men; mean age: 57.1±15.8 years); 27 (77%) had low-grade-typical (19 women, 8 men; mean age: 54.3±14.0 years). The most frequent histological subtype was the meningothelial type in both low-grade (37%) and atypical meningiomas (59%). The mean Ki-67 proliferation index for low-grade and atypical meningiomas were 2.31±1.44% (range: 1-5) and 7.37 ± 2.72% (range: 3-10), respectively. Meningiomas with Ki-67 proliferation index higher than 4% (except one) were atypical (p<0.001). In visual qualitative evaluation; diffusion restriction was significantly more common in atypical meningiomas (p<0.05). In quantitative evaluation, benign and atypical tumor groups had no significant difference in mean ADC values (p=0.471). Conclusion. We suggest that visual qualitative evaluation of DW imaging may be helpful to predict atypia and the risk of recurrence in patients with surgically treated meningiomas.

Keywords:

diffusion weighted imaging, meningioma, surgery, histopathology,

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