脑膜瘤的大小和解剖位置已被证明与不同的临床表现、组织病理学亚型和手术风险相关。然而，脑膜瘤的解剖起源位点在大肿瘤和交叉区室中可能被掩盖。因此，我们寻求应用公正的病灶定位来定位颅内脑膜瘤分布及其与生物学和分级的关系。对成年颅内脑膜瘤患者进行了 MRI 扫描、世界卫生组织 (WHO) 分级和源自细胞遗传学的分子综合分级 (IG) 分析。脑膜瘤。在 T1 加权对比增强 MRI 上进行半自动肿瘤分割。我们使用基于体素的病变绘图技术生成脑膜瘤图谱，绘制空间频率并与肿瘤分级相关联。在 881 名脑膜瘤患者中（中位年龄：57 岁，68.8% 女性），589 名患者为 WHO 1 级（66.8%） 、 265 例 WHO 2 级 (30.1%) 和 27 例 WHO 3 级 (3.1%)，中位肿瘤体积为 14.6 cm3。分子重新分类后，585 例为 IG-1 (66.4%)，160 例为 IG-2 (18.2%)，136 例为 IG-3 (15.4%)。良性肿瘤集中在前颅底中线及其周围，而恶性脑膜瘤则富集于大脑镰/矢状旁区域和蝶骨翼，与按染色体 1p 缺失分层时的分布相似。当按分子 IG 分层时，脑膜瘤表现出比按 WHO 分级更清晰的空间聚类。 WHO 2 级脑膜瘤在 IG 1-3 中均等划分，在前颅底中线（WHO 2 级，IG-1）以及大脑镰/矢状窦和蝶骨区域（WHO 2 级，IG-3）进行了相应的空间分布分区。脑膜瘤体积随年龄、性别和 WHO/IG 分级的不同而存在显着差异。我们展示了基于体素的病变绘图对于颅内肿瘤的实用性，描绘了组织病理学和分子定义分级中不同的脑膜瘤分布模式。分子分级与更清晰的肿瘤空间簇相关，支持脑膜瘤的表型-基因型关联。版权所有 © 神经外科医生大会 2024。保留所有权利。

The size and anatomic location of meningiomas have been shown to correlate with distinct clinical manifestations, histopathological subtypes, and surgical risk. However, meningioma anatomic origin sites can be obscured in large tumors and those crossing compartments. We therefore sought to apply unbiased lesion mapping to localize intracranial meningioma distributions and their association with biology and grade.MRI scans, World Health Organization (WHO) grade, and a molecularly Integrated Grade (IG) derived from cytogenetics were analyzed from adult patients with intracranial meningiomas. Semi-automated tumor segmentation was performed on T1-weighted contrast-enhanced MRI. We used the voxel-based lesion mapping technique to generate a meningioma atlas, mapping spatial frequency and correlating with tumor grades.Of 881 patients with meningioma (median age: 57 years, 68.8% female), 589 were WHO grade 1 (66.8%), 265 WHO grade 2 (30.1%), and 27 WHO grade 3 (3.1%) with a median tumor volume of 14.6 cm3. After molecular reclassification, 585 were IG-1 (66.4%), 160 IG-2 (18.2%), and 136 IG-3 (15.4%). Benign tumors were concentrated in and around the midline anterior skull base while malignant meningiomas were enriched in the falcine/parasagittal region and the sphenoid wing, similar to the distribution when stratified by chromosome 1p loss. Meningiomas exhibited sharper spatial clustering when stratified by the molecular IG than by WHO grade. WHO grade 2 meningiomas divided equally across IG 1-3, with corresponding partition of spatial distribution in the midline anterior skull base (in WHO grade 2, IG-1) and falcine/parasagittal and sphenoid regions (WHO grade 2, IG-3). Meningioma volumes significantly varied across age, sex, and WHO/IG grades.We demonstrate the utility of voxel-based lesion mapping for intracranial tumors, characterizing distinct meningioma distribution patterns across histopathological and molecularly defined grades. Molecular grading associated with sharper tumor spatial clusters, supporting a phenotype-genotype association in meningiomas.Copyright © Congress of Neurological Surgeons 2024. All rights reserved.