{"id":"76d0be46-d2c0-4169-abd9-c69fba201fba","slug":"magnetic-resonance-imaging-fluid-attenuated-inversion-recovery-sequence-signal-reduction-after-endoscopic-endonasal-transcribiform-total-resection-of-olfactory-groove-meningiomas","title":"Magnetic resonance imaging fluid-attenuated inversion recovery sequence signal reduction after endoscopic endonasal transcribiform total resection of olfactory groove meningiomas","authors":["Daniel M. Prevedello","Leo F. S. Ditzel Filho","Juan C. Fernandez-Miranda","Domenico Solari","Marcelo Prudente do Espírito Santo","Allison M. Wehr","Ricardo L. Carrau","Amin B. Kassam"],"abstract":"Background: Olfactory groove meningiomas grow insidiously and compress adjacent cerebral structures. Achieving complete removal without further damage to frontal lobes can be difficult. Microsurgical removal of large lesions is a challenging procedure and usually involves some brain retraction. The endoscopic endonasal approaches (EEAs) for tumors arising from the anterior fossa have been well described; however, their effect on the adjacent brain tissue has not. Herein, the authors utilized the magnetic resonance imaging fluid attenuated inversion recovery (FLAIR) sequence signal as a marker for edema and gliosis on pre- and post-operative images of olfactory groove meningiomas, thus presenting an objective parameter for brain injury after surgical manipulation. Methods: Imaging of 18 olfactory groove meningiomas removed through EEAs was reviewed. Tumor and pre/postoperative FLAIR signal volumes were assessed utilizing the DICOM image viewer OsiriX®. Inclusion criteria were: (1) No previous treatment; (2) EEA gross total removal; (3) no further treatment. Results: There were 14 females and 4 males; the average age was 53.8 years (±8.85 years). Average tumor volume was 24.75 cm3 (±23.26 cm3, range 2.8-75.7 cm3), average preoperative FLAIR volume 31.17 cm3 (±39.38 cm3, range 0-127.5 cm3) and average postoperative change volume, 4.16 cm3 (±6.18 cm3, range 0-22.2 cm3). Average time of postoperative scanning was 6 months (range 0.14-20 months). In all cases (100%) gross total tumor removal was achieved. Nine patients (50%) had no postoperative FLAIR changes. In 2 patients (9%) there was minimal increase of changes postoperatively (2.2 cm3 and 6 cm3 respectively); all others demonstrated image improvement. The most common complication was postoperative cerebrospinal fluid leakage (27.8%); 1 patient (5.5%) died due to systemic complications and pulmonary sepsis. Conclusions: FLAIR signal changes tend to resolve after endonasal tumor resection and do not seem to worsen with this operative technique.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/76d0be46-d2c0-4169-abd9-c69fba201fba/featured/hero-1782420957979.png","publishDate":"2015-10-07T00:00:00.000Z","doi":"10.4103/2152-7806.166846","categories":["Original Article"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2015/10/6297/SNI-6-158.pdf"}