Perfusion MR imaging for differentiation of benign and malignant meningiomas.
BACKGROUND
Our purpose was to determine whether perfusion MR imaging can be used to differentiate benign and malignant meningiomas on the basis of the differences in perfusion of tumor parenchyma and/or peritumoral edema.


METHODS
A total of 33 patients with preoperative meningiomas (25 benign and 8 malignant) underwent conventional and dynamic susceptibility contrast perfusion MR imaging. Maximal relative cerebral blood volume (rCBV) and the corresponding relative mean time to enhance (rMTE) (relative to the contralateral normal white matter) in both tumor parenchyma and peritumoral edema were measured. The independent samples t-test was used to determine whether there was a statistically significant difference in the mean rCBV and rMTE ratios between benign and malignant meningiomas.


RESULTS
The mean maximal rCBV values of benign and malignant meningiomas were 7.16+/-4.08 (mean+/-SD) and 5.89+/-3.86, respectively, in the parenchyma, and 1.05+/-0.96 and 3.82+/-1.39, respectively, in the peritumoral edema. The mean rMTE values were 1.16+/-0.24 and 1.30+/-0.32, respectively, in the parenchyma, and 0.91+/-0.25 and 1.24+/-0.35, respectively, in the peritumoral edema. The differences in rCBV and rMTE values between benign and malignant meningiomas were not statistically significant (P>0.05) in the parenchyma, but both were statistically significant (P<0.05) in the peritumoral edema.


CONCLUSIONS
Perfusion MR imaging can provide useful information on meningioma vascularity which is not available from conventional MRI. Measurement of maximal rCBV and corresponding rMTE values in the peritumoral edema is useful in the preoperative differentiation between benign and malignant meningiomas.
Zhang
Hao
H
Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. zhanghao021@hotmail.com
Rödiger
Lars A
LA
Shen
Tianzhen
T
Miao
Jingtao
J
Oudkerk
Matthijs
M
D000293:Adolescent; D000328:Adult; D001810:Blood Volume; D001929:Brain Edema / Q000209:etiology / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008579:Meningioma / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D008875:Middle Aged
D003287:Contrast Media; D019786:Gadolinium DTPA