Relationship between the Enhanced MRI Features of Preoperative Brain Volume Imaging and Surgical Methods of the Glomus Jugulare Tumor

Abstract

Objective To investigate the relationship between the enhanced MRI features of preopera-tive brain volume imaging (BRAVO) and surgical methods in patients with glomus jugulare tumor (GJT). Methods The imaging data of enhanced BRAVO sequence and surgical methods of patients with GJT confirmed by surgery and pathology from February 2015 to March 2021 in Peking Union Medical College Hospital were analyzed retrospectively. According to the surgical mode, the patients were divided into the groups of single infra-temporal fossa approach (IFA) group and combined infratemporal fossa approach (CIFA) group. Both groups of patients underwent MRI examination before operation, and the Fisch classification of tumor was determined based on the characteristics of enhanced BRAVO sequential images, and the consistency was compared with the Fisch classification determined during the operation. The maximum diameter of the tumor in the transverse axis, the longest diameter in the coronal plane, the width diameter of meningeal invasion and the depth diameter of meningeal invasion were measured and compared between two groups. Results A total of 25 patients were included. Among them, 16 cases were in the IFA group (surgical approach was infratemporal fossa type A), and 9 cases in the CIFA group (surgical approach was infratemporal fossa type A + type B). The classification of image C includes 1 case of C1 type, 10 cases of C2 type, 12 cases of C3 type, and 2 cases of C4 type. The classification of image D includes 8 cases of De1 type, 6 cases of Di1 type, and 5 cases of Di2 type. Except for one patient in the IFA group who was evaluated as C3 preoperatively based on imaging, and confirmed as C2 postoperatively, the image classification of C and D of the other patients were consistent with those of surgical classification of C and D (Kappa=0.934, P < 0.001;Kappa=1.000, P < 0.001). Image classification of C (P=0.029) and D (P=0.006) had significant differences between the two groups. The maximum diameter(P=0.013), depth(P=0.003) and width of meningeal invasion(P=0.011) in the CIFA group were greater than those in the IFA group. There was no significant difference in the longest diameter of the coronal plane (P=0.125) between the two groups. Conclusions Enhanced BRAVO sequence can be used for preoperative evaluation of Fisch classification of GJT. The enhanced image features based on BRAVO sequence showed differences between the two different surgical approaches.

Keywords

• glomus jugulare tumor
• brain volume imaging
• infratemporal fossa approach
• surgical methods