Objective: This study is to investigate the value of intracranial venous circulation evaluation in guiding the surgery for parasagittal meningioma.
Methods: A total of 44 parasagittal meningioma (PSM) patients received 3D CE-MRV scanning. The obtained images were reconstructed by virtual reality (VR) technology. Venous collateral circulation was evaluated. Postoperative follow-up was carried out.
Results: Among 44 PSM patients, 41 cases were with resection of Simpson grade I/II (93.18%) and 6 cases were with permanent neurological dysfunction (13.64%). Venous sinus thrombosis occurred in the remaining 3 patients (6.82%), with 2 cases cured and 1 case died. The mortality rate was 2.27%. Recurrence occurred in one case (2.27%) after discharge. In 9 cases, tumor adjacent SSS was transected and the poor prognosis rate was 33.33%. SSS was opened in 3 cases and after removal of the tumor the broken end was sutured directly. The poor prognosis occurred in one case (33.33%). Electrocoagulation was carried out to the SSS wall in 32 cases without opening venous sinus and 2 cases were with poor prognosis (6.25%). The three different venous sinus treatment methods had no significantly difference on the prognosis of patients (P > 0.05).
Conclusions: Preoperative evaluation of intracranial venous circulation with VR technology and 3D CE-MRV may help making individual surgical plans, reduce venous injury and improve the prognosis of PSM patients.
Keywords: 3D CE-MRV; Parasagittal meningioma; venous collateral circulation; venous protection; virtual reality technology.