Radiation therapy has multiple roles in the treatment of meningioma although surgery remains the primary treatment of choice. In this retrospective study, we report the results of radiation therapy for meningioma as definitive, postoperative or salvage therapies.

Seventeen patients diagnosed with meningioma were treated with radiation therapy in our institute from May 2000 to October 2009. Radiation therapies were performed as definitive therapies in 8 patients, as postoperative therapies in 5 and as salvage therapies in 4. Nine patients received stereotactic radiosurgery (SRS), 2 patients fractionated stereotactic radiotherapy (FSRT), and 5 patients 3-dimensional conformal radiotherapy (3DCRT). Radiation dose were 12 to 20 Gy for SRS, 36 Gy in 9 fractions for FSRT and 50.4 Gy in 28 fractions for 3DCRT. Follow-up imaging study of computed tomography or magnetic resonance imaging was performed at 6 to 12 months intervals and neurologic exam was performed with an interval less than 6 months.

The median follow-up duration was 38 months (range, 12 to 85 months). Tumor progression after radiation therapy developed in one patient. The reduction of tumor volume measured on follow-up images were more than 20% in 4 patients and minimal change of tumor volume less than 20% were observed in 12 patients. Peritumoral edema developed in 4 patients and disappeared without any treatment. One patient had radiation necrosis.

Our experience is consistent with the current understanding that radiotherapy is as an effective and safe treatment modality for meningiomas when the tumor cannot be resected completely or when recurred after surgery.

To evaluate the CT findings of ossicular disruption and fracture utilizing high resolution computed tomography(HRCT) of the temporal bone.

The authors retrospectively reviewed the HRCT scans of 11 patients with ossicular injuries between January 1998 and June 2002 using films in 8 patients, PACS in 3 patients. The type of ossicular injuries, temporal bone fracture, and associated adjacent injuries were evaluated.

Among the 11 patients of ossicular injuries, there were 10 cases of incudomalleal disruption, 4 cases of incudostapedial disruption, and 1 case of fracture of malleus, fracture of incus, disruption of long and lenticular process of incus, nonvisualization of processes of incus. The temporal bone fractures were longitudinal in 7 cases, transverse in l case. Other injuries were fracture of the carotid canal, caroticocavemous fistula, fracture of sphenoid and occipital bones.

Incudomalleal disruption was the most frequent tupe of ossicular injuries and associated temporal bone fracture was longitudinal type. HRCT using PACS was useful in evaluation of ossicular injuries than films.

To determine the computed tomographic findings of cervical lymphadenopathy which distinguish tuberculous lymphadenitis from metastatic lymphadenopathy.

We retrospectively analyzed the CT findings of 21 patients with tuberculous lymphadenitis and 19 with metastatic lymphadenopathy in terms of location, size, shape, presence and shape of necrosis, and presence of extranodal extension.

The tuberculous lymphadenopathy was predominantly located in spinal accessory chain(level V)(42%), but metastatic lymphadinopathy was predominantly located in internal jugular chain(level II)(37%). Of the 21 patients with tuberculous lymphadenitis, the shape was conglomerated lesion with irregular margin in 13 cases. Of the 19 patients with metastatic lymphadenopathy, conglomerated lesion in 4 cases, which were statistically significant(p<0.05). The presence of central necrosis was more frequent in tuberculous lymphadenitis(n=20) than metastatic lymphadenopathy(n=11)(p<0.05). The presence of extranodal extension was significantly different between tuberculous(n=19) and metastatic lymphadenopathy(n=1)(p<0.05).

Cervical tuberculous lymphadenitis frequently involves the spinal accessory chain in young woman. The irregular conglomerated lesion with irregular central necrosis and extranodal extension on CT scan is suggestive of cervical tuberculous lymphadenitis, which is useful in differentiating from metastatic lymphadenopathy.