Magnetic resonance standard for cavernous sinus hemangiomas: proposal for a diagnostic test

Eur Neurol. 2014;72(1-2):116-24. doi: 10.1159/000358872. Epub 2014 Jan 8.

Abstract

Background: By definition, a cavernous sinus is a vascular plexus. A hemangioma is a vascular tumor which is rich in vascular plexus and caused by vascular deformity or tumor-like proliferation. Radiosurgery can effectively control the growth of smaller cavernous sinus hemangiomas (CSHs). This paper aimed to quantify the MRI characteristics of CSHs which provided a basis for further treatment.

Methods: A retrospective analysis was conducted of the MRI characteristics of 133 cavernous sinus lesion patients between January 2006 and December 2009, and none of them was diagnosed without histology. Two groups were set apart according to the pathological results: a CSH group (24 patients) and a non-CSH group (109 patients). The latter was further divided into 3 categories: a meningioma group (33 patients), a neurilemmoma group (37 patients) and a miscellaneous group (39 patients). A single-factor χ(2) analysis was performed to analyze the data on the 12 MRI characteristics.

Results: T2-weighted ultrahigh signal, signal uniformity, dumbbell-like appearance and infiltration of the sellar region were considered statistically significant for the differentiation of CSHs from non-CSHs. If these 4 items served as the diagnostic criteria, the sensitivity, specificity and accuracy was 87.5, 96.3 and 94.7%, respectively.

Conclusion: Smaller CSHs can be treated by radiosurgery directly, without performance of a pathological biopsy.

MeSH terms

  • Cavernous Sinus / pathology*
  • Central Nervous System Neoplasms / diagnosis*
  • Central Nervous System Neoplasms / pathology*
  • Central Nervous System Neoplasms / surgery
  • Hemangioma, Cavernous, Central Nervous System / diagnosis*
  • Hemangioma, Cavernous, Central Nervous System / pathology*
  • Hemangioma, Cavernous, Central Nervous System / surgery
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Meningioma / diagnosis
  • Meningioma / pathology
  • Meningioma / surgery
  • Neurilemmoma / diagnosis
  • Neurilemmoma / pathology
  • Neurilemmoma / surgery
  • Retrospective Studies
  • Sensitivity and Specificity