Risk factors for prediction of prognosis in meningiomas derivable from routine preoperative magnetic resonance imaging (pMRI) remain elusive. Correlations of tumor and edema volume, disruption of the arachnoid layer, heterogeneity of contrast enhancement, enhancement of the capsule, T2-intensity, tumor shape, and calcifications on pMRI with tumor recurrence and high-grade (WHO grade II/III) histology were analyzed in 565 patients who underwent surgery for WHO grade I (N = 516, 91%) or II/III (high-grade histology, N = 49, 9%) meningioma between 1991 and 2018. Edema volume (OR, 1.00; p = 0.003), heterogeneous contrast enhancement (OR, 3.10; p < 0.001), and an irregular shape (OR, 2.16; p = 0.015) were associated with high-grade histology. Multivariate analyses confirmed edema volume (OR, 1.00; p = 0.037) and heterogeneous contrast enhancement (OR, 2.51; p = 0.014) as risk factors for high-grade histology. Tumor volume (HR, 1.01; p = 0.045), disruption of the arachnoid layer (HR, 2.50; p = 0.003), heterogeneous contrast enhancement (HR, 2.05; p = 0.007), and an irregular tumor shape (HR, 2.57; p = 0.001) were correlated with recurrence. Multivariate analyses confirmed tumor volume (HR, 1.01; p = 0.032) and disruption of the arachnoid layer (HR, 2.44; p = 0.013) as risk factors for recurrence, independent of histology. Subgroup analyses revealed disruption of the arachnoid layer (HR, 9.41; p < 0.001) as a stronger risk factor for recurrence than high-grade histology (HR, 5.15; p = 0.001). Routine pMRI contains relevant information about the risk of recurrence or high-grade histology of meningioma patients. Loss of integrity of the arachnoid layer on MRI had a higher prognostic value than the WHO grading, and underlying histological or molecular alterations remain to be determined.

中文翻译：

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使用常规术前 MRI 预测颅内脑膜瘤患者术后复发和高级别组织学的风险。

常规术前磁共振成像 (pMRI) 预测脑膜瘤预后的危险因素仍然难以捉摸。肿瘤和水肿体积、蛛网膜层破坏、对比增强的异质性、包膜增强、T2 强度、肿瘤形状和 pMRI 上的钙化与肿瘤复发和高级别（WHO II/III 级）组织学的相关性是对 1991 年至 2018 年间接受 WHO I 级（N = 516, 91%）或 II/III（高级别组织学，N = 49, 9%）脑膜瘤手术的 565 名患者进行分析。水肿体积（OR，1.00；p = 0.003)、异质对比增强 (OR, 3.10; p < 0.001) 和不规则形状 (OR, 2.16; p = 0.015) 与高级组织学相关。多变量分析证实水肿体积（OR，1.00；p = 0。037) 和异质对比增强 (OR, 2.51; p = 0.014) 作为高级组织学的危险因素。肿瘤体积 (HR, 1.01; p = 0.045)、蛛网膜层破坏 (HR, 2.50; p = 0.003)、异质对比增强 (HR, 2.05; p = 0.007) 和不规则的肿瘤形状 (HR, 2.57; p = 0.001）与复发相关。多变量分析证实肿瘤体积（HR，1.01；p = 0.032）和蛛网膜层破坏（HR，2.44；p = 0.013）是复发的危险因素，与组织学无关。亚组分析显示蛛网膜层的破坏（HR，9.41；p < 0.001）是比高级组织学（HR，5.15；p = 0.001）更强的复发风险因素。常规 pMRI 包含有关脑膜瘤患者复发风险或高级别组织学的相关信息。