Utilization of dynamic CT perfusion in the study of intracranial meningiomas and their surrounding tissue.
OBJECTIVE
To use CT perfusion (CTP) to assess levels of ischemia in brain areas around intracranial meningiomas.


METHODS
Fifteen patients with intracranial meningiomas were analysed preoperatively with CTP study. The cerebral blood flow (CBF), cerebral blood volume (CBV) and time to peak (TTP) were measured in the edema, peritumoral edema and in the normal areas of brain.


RESULTS
The peritumoral edema measured a mean CBF of 17.36 ml/min/100 ml (median=15.8) and the mean CBF value in the whole edema was 93.86 ml/min/100 ml (median=79.9). The mean CBV measured in the peritumoral edema was 2.7 (median=2.3) and the measured mean CBV of edema was 15 (median=13.2). In the region of the peritumoral edema, the mean CBF and CBV were lower than in the edema bed. Normal brain remote from the edema measured less CBF (mean=28.36 ml/min/100 ml, median=29.7) and CBV (mean=4.1, median=3.8) than the edema. Six patients were noted to have CBF of less than 15 ml/min/100 ml in the perilesional edema. The measured mean CBF and CBV in the normal area of brain were higher than in the peritumoral edema, while the TTP was greater in the perilesional edema (mean=11, median=10.4) when compared with areas of normal brain (mean=9.9, median=9.5) with statistically significant p values.


CONCLUSIONS
The values obtained elucidate the fact that perilesional edematous areas are ischemic. By subset analysis, it may be possible to identify those areas with recoverable tissue from non-recoverable tissue.
Sergides
Ioannis
I
Department of Neurosciences, Kings College Hospital, London SE5 9RS, UK. ysergides@hotmail.com
Hussain
Zakier
Z
Naik
Sunil
S
Good
Catriona
C
Miles
Ken
K
Critchley
Giles
G
D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D001929:Brain Edema / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000502:physiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging*; D008579:Meningioma / Q000000981:diagnostic imaging*; D012984:Software; D014057:Tomography, X-Ray Computed