Preoperative assessment of intracranial tumors with perfusion MR and a volumetric interpolated examination: a comparative study with DSA.
OBJECTIVE
In evaluating intracranial tumors, a safe low-cost alternative that provides information similar to that of digital subtraction angiography (DSA) may be of interest. Our purpose was to determine the utility and limitations of a combined MR protocol in assessing (neo-) vascularity in intracranial tumors and their relation to adjacent vessels and to compare the results with those of DSA.


METHODS
Twenty-two consecutive patients with an intracranial tumor who underwent preoperative stereoscopic DSA were examined with contrast-enhanced dynamic T2*-weighted perfusion MR imaging followed by a T1-weighted three-dimensional (3D) MR study (volumetric interpolated brain examination [VIBE]). The maximum relative cerebral blood volume (rCBV) of the tumor was compared with tumor vascularity at DSA. Critical vessel structures were defined in each patient, and VIBE images of these structures were compared with DSA findings. For full exploitation of the 3D data sets, maximum-intensity projection algorithms reconstructed in real time with any desired volume and orientation were used.


RESULTS
Tumor blush scores at DSA were significantly correlated with the rCBV measurements (r = 0.75; P <.01, Spearman rank correlation coefficient). In 17 (77%) patients, VIBE provided all relevant information about the venous system, whereas information about critical arteries were partial in 50% of the cases and not relevant in the other 50%.


CONCLUSIONS
A fast imaging protocol consisting of perfusion MR imaging and a volumetric MR acquisition provides some of the information about tumor (neo-) vascularity and adjacent vascular anatomy that can be obtained with conventional angiography. However, the MR protocol provides insufficient visualization of distal cerebral arteries.
Wetzel
Stephan G
SG
Department of Radiology, New York University Medical Center, New York, NY 10016, USA.
Cha
Soonmee
S
Law
Meng
M
Johnson
Glyn
G
Golfinos
John
J
Lee
Peter
P
Nelson
Peter Kim
PK
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001810:Blood Volume / Q000502:physiology*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000503:physiopathology*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D002540:Cerebral Cortex / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009518:New York; D011300:Preoperative Care; D012008:Recurrence; D012720:Severity of Illness Index; D013223:Statistics as Topic