Abstract：
OBJECTIVE: The objective of this study was to investigate the role of the foramen of Vesalius (FV) in the pathogenesis of skull base meningioma by analyzing data from various multi-image modalities.
METHODS: For this single-center retrospective study, 39 consecutive patients with skull base meningioma who underwent tumor resection between January 2020 and March 2023 were enrolled. The anatomical and pathological characteristics of the FV were evaluated using computed tomography and 3-dimensional digital subtraction angiography. The clinical significance of the FV in tumor hemodynamics and treatment, such as preoperative tumor embolization, was investigated using the 3-dimensional digital subtraction angiography/computed tomography fusion images.
RESULTS: We identified FV in 52% (17/27) of the finally included patients. In 10 (30%) patients, the FV was found bilaterally with no significant variation in appearance between the healthy and tumor-affected sides (P = 0.786). The mean FV diameter was significantly larger on the tumor-affected side (P = 0.010). No significant anatomical differences, like duplication and partial assimilation with the foramen ovale, were observed between the 2 sides. The FV was involved in venous skull base perfusion around the tumor in 9 cases. In 4 cases where it was the pathway for tumor feeders, preoperative tumor embolization via the FV resulted in disappearance of the tumor stain. No complications associated with endovascular treatment were observed.
CONCLUSIONS: This study elucidated the anatomical asymmetry of the FV and its role in the hemodynamics of skull base meningioma. Our findings highlight the significance of performing anatomical and pathological evaluations of the FV in determining treatment strategies, including preoperative embolization, for skull base lesions.
METHODS: For this single-center retrospective study, 39 consecutive patients with skull base meningioma who underwent tumor resection between January 2020 and March 2023 were enrolled. The anatomical and pathological characteristics of the FV were evaluated using computed tomography and 3-dimensional digital subtraction angiography. The clinical significance of the FV in tumor hemodynamics and treatment, such as preoperative tumor embolization, was investigated using the 3-dimensional digital subtraction angiography/computed tomography fusion images.
RESULTS: We identified FV in 52% (17/27) of the finally included patients. In 10 (30%) patients, the FV was found bilaterally with no significant variation in appearance between the healthy and tumor-affected sides (P = 0.786). The mean FV diameter was significantly larger on the tumor-affected side (P = 0.010). No significant anatomical differences, like duplication and partial assimilation with the foramen ovale, were observed between the 2 sides. The FV was involved in venous skull base perfusion around the tumor in 9 cases. In 4 cases where it was the pathway for tumor feeders, preoperative tumor embolization via the FV resulted in disappearance of the tumor stain. No complications associated with endovascular treatment were observed.
CONCLUSIONS: This study elucidated the anatomical asymmetry of the FV and its role in the hemodynamics of skull base meningioma. Our findings highlight the significance of performing anatomical and pathological evaluations of the FV in determining treatment strategies, including preoperative embolization, for skull base lesions.
摘要：
目的：通过分析各种多图像方式的数据，探讨Vesalius孔（FV）在颅底脑膜瘤发病机制中的作用。
方法：对于这项单中心回顾性研究，纳入了在2020年1月至2023年3月期间接受肿瘤切除术的39例颅底脑膜瘤患者。使用计算机断层扫描（CT）和三维（3D）数字减影血管造影（DSA）评估FV的解剖和病理特征。FV在肿瘤血流动力学及治疗中的临床意义,如术前肿瘤栓塞，使用3D-DSA/CT融合图像进行了研究。
结果：我们确定了最终纳入患者的52%（17/27）的FV。在10名（30％）患者中，双侧发现FV，健康侧和肿瘤患侧之间的外观没有显着差异（p=0.786）。在受肿瘤影响的一侧，平均FV直径明显更大（p=0.010）。没有显著的解剖学差异，比如与卵圆孔的重复和部分同化，在双方之间观察到。9例FV参与肿瘤周围颅底静脉灌注。在四种情况下，它是肿瘤饲养者的途径，术前通过FV进行肿瘤栓塞导致肿瘤染色消失。未观察到与血管内治疗相关的并发症。
结论：这项研究阐明了FV的解剖不对称性及其在颅底脑膜瘤的血流动力学中的作用。我们的发现突出了对FV进行解剖和病理评估在确定治疗策略中的意义。包括术前栓塞,颅底病变.
方法：对于这项单中心回顾性研究，纳入了在2020年1月至2023年3月期间接受肿瘤切除术的39例颅底脑膜瘤患者。使用计算机断层扫描（CT）和三维（3D）数字减影血管造影（DSA）评估FV的解剖和病理特征。FV在肿瘤血流动力学及治疗中的临床意义,如术前肿瘤栓塞，使用3D-DSA/CT融合图像进行了研究。
结果：我们确定了最终纳入患者的52%（17/27）的FV。在10名（30％）患者中，双侧发现FV，健康侧和肿瘤患侧之间的外观没有显着差异（p=0.786）。在受肿瘤影响的一侧，平均FV直径明显更大（p=0.010）。没有显著的解剖学差异，比如与卵圆孔的重复和部分同化，在双方之间观察到。9例FV参与肿瘤周围颅底静脉灌注。在四种情况下，它是肿瘤饲养者的途径，术前通过FV进行肿瘤栓塞导致肿瘤染色消失。未观察到与血管内治疗相关的并发症。
结论：这项研究阐明了FV的解剖不对称性及其在颅底脑膜瘤的血流动力学中的作用。我们的发现突出了对FV进行解剖和病理评估在确定治疗策略中的意义。包括术前栓塞,颅底病变.
