Quantitative Assessment of Flow Reduction After Feeder Embolization in Meningioma by Using Pseudocontinuous Arterial Spin Labeling.
BACKGROUND
Meningioma is a hypervascular tumor of the central nervous system. Angiographic disappearance of tumor blush after preoperative feeder embolization allows qualitative, but not quantitative, assessment of flow reduction. Pseudocontinuous arterial spin labeling (PCASL), which has evolved from magnetic resonance imaging techniques, allows noninvasive measurement of cerebral blood flow (CBF) using water protons in the arterial blood flow.


OBJECTIVE
We applied PCASL for assessment of blood flow in meningioma and its reduction on preoperative embolization.


METHODS
Forty-one consecutive patients (11 males, 30 females) with histologically proven meningioma were evaluated by PCASL. Quantitative assessment by an absolute value of tumor blood flow (TBF) and a relative value of tumor vascular index (tVI; calculated as TBF divided by CBF) were calculated. In 8 cases, in which preoperative embolization was achieved, flow reduction rate was evaluated.


RESULTS
TBF of meningiomas, 155.8 mL/100 g·min(-1) on average, was 2.6 times higher than CBF, 59.9 mL/100 g·min(-1) (P < 0.001). Patients who underwent feeder embolization showed statistically greater flow reduction rate, which was calculated as 42.7% (P < 0.05). Mean tVI before embolization was 4.1, which was reduced to 2.1 after embolization.


CONCLUSIONS
PCASL could yield quantitative assessment of blood flow in meningioma including flow reduction rate in cases of feeder embolization.
Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Masahiko
M
Wanibuchi
Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan. Electronic address: komatsu1@sapmed.ac.jp.
Katsuya
K
Komatsu
Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Yukinori
Y
Akiyama
Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Takeshi
T
Mikami
Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Satoshi
S
Iihoshi
Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Kei
K
Miyata
Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Nobuhiro
N
Mikuni
D000328:Adult; D001783:Blood Flow Velocity; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D008579:Meningioma / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000517:prevention & control*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels; D016896:Treatment Outcome; D055815:Young Adult
D013113:Spin Labels
Feeder embolization; Magnetic resonance imaging; Meningioma; Pseudocontinuous arterial spin labeling; Tumor blood flow