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BRAIN and NERVE Volume 60, Issue 3 （March 2008）

BRAIN and NERVE 60巻3号（2008年3月発行）

Japanese English

原著

脳ドックにおける髄膜腫の偶発頻度と臨床放射線学的検討 Clinicoradiological Studies and Frequency of Incidental Meningiomas on Brain Check-up 池田憲 ^1,2 , 樫原英俊 ¹ , 細沢健一 ¹ , 阿南耕三 ¹ , 田村政紀 ¹ , 岩本康之介 ² , 伊藤裕乃 ² , 川瀬裕士 ² , 岩崎泰雄 ² Ken Ikeda ^1,2 , Hidetoshi Kashihara ¹ , Ken-ichi Hosozawa ¹ , Kozo Anan ¹ , Masaki Tamura ¹ , Konosuke Iwamoto ² , Hirono Ito ² , Yuji Kawase ² , Yasuo Iwasaki ² ¹PL東京健康管理センター神経内科 ²東邦大学医療センター大森病院神経内科 ¹Department of Neurology, PL Tokyo Health Care Center ²Department of Neurology, Toho University Omori Medical Center キーワード： asymptomatic meningioma , incidental frequency , brain check-up , MRI , female Keyword: asymptomatic meningioma , incidental frequency , brain check-up , MRI , female pp.273-278

発行日 2008年3月1日 Published Date 2008/3/1

DOI https://doi.org/10.11477/mf.1416100243

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はじめに

　髄膜腫は成人で最もよく遭遇する原発性脳腫瘍である^1）。最近では脳ドックが徐々に普及してきた結果，偶然発見されるケースが増加しているのが現状である^2，3）。さらに，何らかの主訴を持って来院する外来診療で施行される頭部magnetic resonance imaging（MRI）でも髄膜腫が偶然に描出される患者も経験する。そこで，無症候性髄膜腫の有病率は脳ドックやMRIの普及により，確実に増加してくると推察される。しかし，わが国に特有な脳ドック健診を介して，偶発に描出される無症候性髄膜腫の頻度を算出した報告は少ない^4）。今回われわれは，脳ドック受診者を対象に髄膜腫が偶然に発見される頻度と臨床放射線学的所見を分析した。本調査の結果を主に，本邦の脳神経外科からの報告と比較検討したので報告する。

Abstract

　The purpose of this study is to evaluate clinico-radiological findings and to estimate frequency of incidental meningiomas detected by brain check-up (BC).　A total of 12,258 healthy adults (8,515 men and 3,743 women) had BC, using physical check-up, brain magnetic resonance imaging (MRI) and MR angiography.　Mean age (SD) was 52.6 (11.4) years, 52.7 (11.2) in men and 52.5 (11.8) in women.　Duration of this study was between April 2004 and March 2007.　BC subjects were divided into the first BC and the repeated BC group.　The number of the first BC subjects was 5,056 (3,284 men and 1,772 women).　In the repeated group defined that they had the first BC before April 2004 in our center, there were 7,202 subjects (5,231 men and 1,971 women).　Fifteen subjects (7 men and 8 women) were diagnosed as meningiomas.　Fourteen cases were detected by the first BC and one case by the repeated BC.　The percentage of incidental meningiomas in the first BC group was calculated as 0.28, 0.18 in men and 0.45 in women.　The sex ratio of women/men was 2.5.　The mean age of those cases was 55.2 (10.1), 54.6 (12.9) in men and 55.8 (7.7) in women.　Incidental rate of meningioma in the repeated BC group was calculated as 0.01 % and 0.02 % in men.　No subjects had meningioma at age ≦ 30 years.　Asymptomatic meningiomas were seen in 14 cases (93.3 %) and they expected BC to ascertain healthy and normal brain by themselves.　The size of tumors was ranged 10 to 46 mm and mean (SD) was 21.3 (10.2) mm.　The locations of meningiomas were variable.　Three cases had surgical removal.　Twelve cases were under investigation on MRI.　In middle-aged working subjects, incidental rates of asymptomatic meningiomas detected by BC are not uncommon in Japan.　We should pay more attention to incidental meningioma when brain MRI is performed in 40～60 years women.