543 Vol. 33, pp. 543 549, 2005 : 18 1 11 MRI 1 Nakasu 2 40 0.5 40 60 1.2 1.3 60 2.4 70 3.6 80 4.6 30 1cm 3cm 50 3cm Kuratsu 3 27 8 1563 504 32.2 196 38.9 10 3.1 1.2 70 196 79 40.3 70 Rohringer 4 1980 8 193 10 2.3 70 10 8.4 18 121 35 28.9 5 Annegers 6 10 9.2 MRI Onizuka 7 4000 MRI 11 0.28 6 0.15 37
544 1990 1993 3168 50.3 Onizuka 7 1982 1983 8 CT CT MRI 3cm 10 1 3 5 9 12 Table 1 selection bias Kuratsu 3 196 87 1 Table 1 65 Niiro 10 70 2 2.5cm 3 17.5 47.2 1 5 10 Niiro 10 5 2 2.5 cm negative factor 4 1 2 3 Fig. 1 4 1 2 3 13 14 CT moderate hyperdensity mushrooming 15 4 3cm 4cm 14 Fig. 2 Fig. 3 16 MRI MRI 6 2 1 MRI 38
545 Table 1 39
»¼-. 546 Fig. 1 71 ῌ / s?@ab MRI / a G H : MRI T 1 ῌ 6 Z3@}~ H! X b" 3 s G H LM s # # F; 3 $%&/ s' K ῌ : H! X# ; ῌ LM Simpson grade 1 ab ª ῌ ( «atypical meningioma K ῌ Fig. 2 45 ῌ / s?@ B MRI / a G H ῌ T2 ±b H!²³/)H# ; T1 ±b H! *b +µ,i ¹ 73º #>F3ῌ LM Simpson grade 1 K ῌ )*+,-. 6 73ῌ 8 ;/ 6 ῌ!"# $%& 7\] '( /012 "3ῐ 4 732//9 X Y /Z TU" Z7/F 7 [ 2 ; ῌ G H /^_?@` ab 45 cdlm 3ῌ 37 e O7G H F & : 7hi 2jk < => 3ῌ o p /q g>s u ῐ ῒῑΐ ῌ fxg c l& m LMn 3ῌ rs dlm g t 717 ῌ v w x "3Z f Simpson s grade 2 /LM 2 grade 1 <y?@ab/cdef;g H I J/ /z{# ; Marmood ;18 5.1 /@ K AB&LM NO )*+,-. }~ t 183 2 2ῑ PQ-RS,-. 7K $%& 73ῌ #K & dlm v w '( ῌra- t diosurgery #TUV 5>K ῌ TUV/W 40 u 7ῌ F #;
547 Fig. 3 56 MRIT2 T1 Simpson grade 2 1990 19 mortality morbidity 20 Linsky 20 14 38 7.85 cm 3 GKS 21.5 96.8 Roche 21 92 5.8 cm 3 GKS 30.5 92.8 54 8 15 1 GKS 22 Fig. 4 23 24 Singh 23 GKS 26 17 Chang 24 179 GKS 97.1 37.3 23.6 40 5mm 41
m»¼ 548 Fig. 4 73 { ῌ 14 8} 3/ ~ # $%& H N ῌ 2 8}02NF+ 1y *2+ ῑ1 / H / ῌ MRIT2 X ῌ O 1*2+ T1 X } a + ῒ H ª «1*2+ ῌ Late radiation e#ect ;<H F ῒ ±² ~ ³ } µ " H / ῌ < D ¹º/ ῌ 1718ῐ1720.!"# $ 6 Annegers JF, Schoenberg BS, Okazaki H, Kur- %& ' () *+,-. ῌ /0/ 1 land LT. Epidemiologic study of primary in- 2 34 9: 7ῐ6 "DE FG 56 78ῐ tracranial neoplasms. Arch Neurol 1981; 38: ;<=>?@/ ABC! 25 26 HI C 217ῐ219. JK L 7 Onizuka M, Suyama K, Shibayama A, Hiura M N+, 2 Fῌ T, Horie N, Miyazaki H. Asymptomatic brain tumor detected at brain checkῐup. Neurol Med ῌ Chir ῌTokyo 2001; 41: 431ῐ435. 8 O 1 The Committee of Brain Tumor Registry of ῒPQRSTUV: O ῒPQWSXYZ [ vol. 7 ῌ1969ῐ1983 1990. Japan: Report of Brain Tumor Registry of Japan ῌ1963ῐ1993 10 th Edition. Neurol Med 9 Olivero WC, Lister JR, Elwood PW. The natu- Chir ῌTokyo Suppl vol. 40 January, 2000. ral history and growth rate of asymptomatic 2 Nakasu S, Hirano A, Shimura T, Llena JF. meningiomas: a review of 60 patients. J Neuro- Incidental meningioma in autopsy study. Surg surg 1995; 83: 222ῐ224. Neurol 1987; 27: 319ῐ322. 10 Niiro M, Yatsushiro K, Nakamura K, Kawa- 3 Kuratsu J, Kochi M, Ushio Y. Incidence and hara Y, Kuratsu J. Natural history of elderly clinical features of asymptomatic meningio- patients with asymptomatic meningiomas. J mas. J Neurosurg 2000; 92: 766ῐ770. Neurol Neurosurg Psychiatry 2000; 68: 25ῐ28. 4 Rohringer M, Sutherland GR, Louw DF, 11 Yoneoka Y, Fujii Y, Tanaka R. Growth of Sima AAF. Incidence and clinicopathological incidental meningiomas. Acta Neurochir ῌWien 2000; 142: 507ῐ511. features of meningioma. J Neurosurg 1989; 71: 12 \]^_ `abc defg hijk l 665ῐ672. m n opqr st`uv w]xῌ 5 Go RS, Taylor BV, Kimmel DW. The natural Radiosurgery yz history of asymptomatic meningiomas in Olm- O 2003; 31: 891ῐ897. sted County, Minnesota. Neurology 1998; 51: 42 3C
549 13 Ojemann SG, Sneed PK, Larson DA, Gutin PH, Berger MS, Verhey L, Smith V, Petti P, Wara W, Park E, McDermott MW. Radiosurgery for malignant meningioma: results in 22 patients. J Neurosurg Suppl 3 2000; 93: 62 67. 14 2001; 53: 327 330. 15 Ginsberg LE, Moody DM. Meningiomas: imaging. In: Wilkins RH, Rengachary SS eds, Neurosurgery. Second ed. Vol I. McGraw- Hill, New York, 1996: 855 872. 16 4 2004; 56: 29 32. 17 Simpson D. The recurrence of intracranial meningiomas after surgical resection. J Neorol Neurosurg Psychiatry 1957; 201: 22 39. 18 Mahmood A, Qureshi NH, Malik GM. Intracranial meningiomas: analysis of recurrence after surgical treatment. Acta Neurochir Wien 1994; 126: 53 58. 19 Taguchi Y. Recent advances in surgical approaches to parasellar lesions. St. Marianna Med J 2004; 32: 219 226. 20 Linsky ME, Davis SA, Ratanatharathorn V. Relative roles of microsurgery and stereotactic radiosurgery for the treatment of patients with cranial meningiomas: a single-surgeon 4-year integrated experience with both modalities. J Neurosurg Suppl 2005; 102: 59 70. 21 Roche PH, Regis J, Dufour H, Fournier HD, Delsanti C, Pellet W, Grisoli F, Peragut JC. Gamma knife radiosurgery in the management of cavernous sinus meningiomas. J Neurosurg Suppl 3 2000; 93: 68 73. 22 Kobayashi T, Kida Y, Mori Y. Long-term results of stereotactic gamma radiosurgery of meningiomas. Surg Neurol 2001; 55: 325 331. 23 Singh VP, Kansal S, Vaishya S, Julka PK, Mehta VS. Early complications following gamma knife radiosurgery for intracranial meningiomas. J Neurosurg Suppl 3 2000; 93: 57 61. 24 Chang JH, Chang JW, Choi JY, Park YG, Chung SS. Complications after gamma knife radiosurgery for benign meningiomas. J Neurol Neurosurg Psychiatry 2003; 74: 226 230. 25 Awad IA, Kalfas I, Hahn JF, Little JR. Intracranial meningiomas in the aged: surgical outcome in the era of computed tomography. Neurosurgery 1989; 24: 557 560. 26 Caroli M, Locatelli M, Prada F, Beretta F, Martinelli Boneschi F, Campanella R, Arienta C. Surgery for intracranial meningiomas in the elderly: a clinical-radiological grading system as a predictor of outcome. J Neurosurg 2005; 102: 290 294. 43