Assessment of vascular supply of hypervascular extra-axial brain tumors with 3T MR regional perfusion imaging.
OBJECTIVE
The vascular supply of extra-axial brain tumors provided by the external carotid artery has not been studied with RPI. The purpose of this work was to determine whether RPI assessment is feasible and provides information on the vascular supply of hypervascular extra-axial brain tumors.


METHODS
Conventional ASL and RPI studies were performed at 3T in 8 consecutive patients with meningioma. On the basis of MRA results, we performed RPI by placing a selective labeling slab over the external carotid artery. Five patients underwent DSA before surgery. Two neuroradiologists independently evaluated the overall image quality, the degree of tumor perfusion, and the extent of the tumor vascular territory on conventional ASL and RPI.


RESULTS
In overall quality of conventional ASL and RPI, no images interfered with interpretation. In comparisons of the vascular tumor territory identified by the conventional ASL and RPI techniques, the territories coincided in 3 cases, were partially different in 4, and completely different in 1. The interobserver agreement was very good (kappa = 0.82). In 5 patients who underwent DSA, the 4 patients in whom the dominant supply was the external carotid artery were scored as coincided or partially different. The 1 patient in whom the vascular supply was from the internal carotid artery was scored as completely different.


CONCLUSIONS
RPI with selective labeling of the external carotid artery is feasible and may provide information about the vascular supply of hypervascular extra-axial brain tumors.
Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
A
A
Sasao
T
T
Hirai
S
S
Nishimura
H
H
Fukuoka
R
R
Murakami
M
M
Kitajima
T
T
Okuda
M
M
Akter
M
M
Morioka
S
S
Yano
H
H
Nakamura
K
K
Makino
J-i
JI
Kuratsu
K
K
Awai
Y
Y
Yamashita
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002342:Carotid Artery, External / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002426:Cavernous Sinus / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008577:Meningeal Neoplasms / Q000098:blood supply* / Q000473:pathology* / Q000601:surgery; D008579:Meningioma / Q000098:blood supply* / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D011300:Preoperative Care