Correlation Between MRI Features Of Meningioma And Postoperative Cerebral Edema Exacerbation

Purpose: In order to analyze the relationship between imaging features of patients with meningioma in Cerebral MRI examination before operation and postoperative cerebral edema exacerbation(CEE),to explore the correlation and rule between them,so as to prevent and treat the patients as soon as possible,so as to reduce the adverse prognosis of the patients.Methods: The clinical data of 113 patients with meningioma from the Department of Neurosurgery,the Second Affiliated Hospital of Dalian Medical University from January 2020 to January 2023 were collected and analyzed retrospectively.All patients were treated with meningioma resection under craniotomy microscope.To establish appropriate inclusion and exclusion criteria,patients with meningioma in the study were divided into CEE and non-CEE groups.The patient’s age(≤60Y,> 60Y),gender(male,female),tumor size(< 2cm,2-5cm,> 5cm),tumor site(parasinusium,skull base,convex surface,other),tumor morphology(regular,irregular),empty shadow of blood flow(present,absent),preoperative peritumoral edema(present,absent),and meningeal tail sign(present,absent)were investigated In),uniform enhancement(uniform,uneven),tumor-brain interface(clear,unclear)and other MRI features and CEE correlation.Firstly,the correlation analysis of MRI features of each meningioma was performed to compare the differences between the two groups of patients in related factors.Then,the factors with statistical difference were analyzed by binary logistic regression to determine the independent risk factors of CEE.Then,the predictive model of CEE for meningioma patients was established by SPSS software to generate receiver operating characteristic curve(ROC).Finally,the area under the curve(AUC)was used to evaluate the predictive value of CEE for meningioma patients.Results:1.In this study,40 of 113 patients with meningioma developed CEE after surgery,with an incidence of 35.3%.Through univariate analysis,six MRI features,including tumor site,size,shape,preoperative peritumoral edema,uniform enhancement,and clear tumor brain interface,were correlated with the occurrence of increased cerebral edema after meningioma.There was statistical significance(P < 0.05).There was no correlation between age,gender,meningococcal tail sign and empty blood flow shadow,and the results were not statistically significant.2.Binary logistic regression analysis showed that the tumor site P=0.003(<0.05),preoperative peritumoral edema P=0.001(<0.05),and the tumor-brain interface P=0.000(<0.05)had statistical significance,indicating that these MRI features were independent factors of CEE.3.The β value of peritumoral edema in binary logistic regression analysis was-3.154,indicating that preoperative peritumoral edema was negatively correlated with CEE,and the presence of preoperative peritumoral edema in patients with meningioma had a protective effect on CEE.4.Three factors,including tumor site,preoperative peritumoral edema and tumor-brain interface,were taken as test variables,and the occurrence of CEE was taken as state variable to draw ROC curve and establish CEE prediction model.The AUC of preoperative peritumoral edema was 0.270.Considering that preoperative peritumoral edema was negatively correlated with CEE,and preoperative peritumoral edema was a dichotomous variable,the CEE value of preoperative no peritumoral edema was0.730(> 0.5),indicating good predictive value.The AUC of tumor site was0.416(< 0.5),indicating poor predictive value.The AUC of the tumor-brain interface was 0.822(> 0.5),indicating good predictive value.The AUC of logistic regression analysis was 0.935,showing a higher prediction value.Conclusion:1.Tumor site,tumor size,tumor shape,peritumoral edema,uniform enhancement,and tumor-brain interface were correlated with CEE exacerbation.2.Three MRI features of meningioma,including tumor site,preoperative peritumoral edema,and tumor-brain interface,were independent factors of CEE.3.Preoperative peritumoral edema is negatively correlated with CEE exacerbation,and preoperative peritumoral edema has a protective effect on CEE.4.Preoperative peritumoral edema and tumor-brain interface showed good performance in CEE prediction model.