Angiographic Characteristics of Metastatic Brain Tumor:Morphologic Classification of Tumor Stains and Angiographic Diagnosis Tornio OHTA 1 , Shuro NISHIMURA 1 1Department of Neurosurgery, Osaka City University Medical School pp.1226-1232
Published Date 1969/11/1
DOI https://doi.org/10.11477/mf.1406202627
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 Increased occurrence of the metastatic brain tumor has been closed up years by years and its propriety of surgical management has been discussed with incompatible data. This investigation has been undertaken in order to know whether or not metastatic brain tumors could be predicted preoperatively by angiographic characteristics of tumor stainings.

 1) Forty-seven cases of metastatic brain tumors have been treated in out department and Kitano Hospital, Osaka. All of these cases have been diagnosed by a carotid angiography alone, so that metastasis in infratentorial space is excluded in our present analyses. Existance of space-occupying mass could be diagnosed angiographically in 38 out of 47 cases, and different patterns of tumor stains were noted in 17 out of 38 cases mentioned above (45%). Analysis of angiographic tumor stainings in 17 cases of metastatic brain tumors has been compared with those of glioblastoma multiforme and meningioma, because of angiographic similarity of their tumor stainings.

 2) Pathologic stainings in a carotid angiography have been classified into 5 patterns (Table 1). The typical type in the metastatic brain tumor has been noticed as a diffusely spotty staining, while a roughly granular staining in glioblastoma multiforme and homogenously diffuse staining in meningioma (Table 3).

 3) Circulatory velocity of contrast media in the tumor has been estimated in contrasting the densities of the tumor stainings in arterial, capillary and venous phases respectively. In case of glioblastoma multiforme the most dense tumor stain has been seen in arterial phase followed by a capillary phase. Tumor stain has already been disappeared in half cases of glioblastoma multiforme, while the most dense tumor stain in meningioma has been demonstrated in a capillary phase followed by a venous phase. In an arterial phase of meningioma tumor stain has not been seen yet in 8 out of 14 cases (57%) which means slow circulation in tumor mass.

 The most dense tumor stain in case of the metastatic brain tumor has been demonstrated in capillary phase followed by an arterial and venous phases, which means intermediate circulatory velocity between glioblastoma multiforme and meningioma with closer similarity to cases of glioblastoma multiforme.

 4) Above mentioned analyses have taught us that the typical characteristics of angiographic tumor stain in case of the metastatic brain tumor has been diffusely spotty in type and in relatively rapid circulation of contrast media. The arrangement of tumor stain, I (⧺) -I (⧻)-I (+) shown in Table 5 has been specifically seen in cases of the metastatic brain tumor, which, however, has been demonstrated in only 6 out of 17 cases (34%).

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