title: Evaluation of the applicability of territorial arterial spin labeling in meningiomas for presurgical assessments compared with 3-dimensional time-of-flight magnetic resonance angiography.
abstract: OBJECTIVE
  To prospectively evaluate the application of territorial arterial spin labelling (t-ASL) in comparison with unenhanced three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) in the identification of the feeding vasculature of meningiomas.
  
  
  METHODS
  Thirty consecutive patients with suspected meningiomas underwent conventional MR imaging, unenhanced 3D-TOF-MRA and t-ASL scanning. Four experienced neuro-radiologists assessed the feeding vessels with different techniques separately.
  
  
  RESULTS
  For the identification of the origin of the feeding arteries on t-ASL, the inter-observer agreement was excellent (к = 0.913), while the inter-observer agreement of 3D-TOF-MRA was good (к = 0.653). The inter-modality agreement between t-ASL and 3D-TOF-MRA for the feeding arteries was moderate (к = 0.514). All 8 patients with motor or sensory disorders proved to have meningiomas supplied completely or partially by the internal carotid arteries, while all 14 patients with meningiomas supplied by the external carotid arteries or basilar arteries didn't show any symptoms concerning motor or sensory disorders (p = 0.003).
  
  
  CONCLUSIONS
  T-ASL could complement unenhanced 3D-TOF-MRA and increase accuracy in the identification of the supplying arteries of meningiomas in a safe, intuitive, non-radioactive manner. The information about feeding arteries was potentially related to patients' symptoms and pathology, making it more crucial for neurosurgeons in planning surgery as well as evaluating prognosis.
  
  
  CONCLUSIONS
  • A comprehensive understanding of feeding vasculature is helpful for optimized treatment decisions. • T-ASL could identify main supplying arteries of meningiomas with excellent inter-observer agreement. • The inter-modality agreement for identification of the main feeding arteries was moderate. • Blood supply from ICAs was related to motor or sensory disorders. • High-level meningiomas were found to have double main supplying arteries.
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai, 200040, China.
authors.forename: Yiping
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai, 200040, China.
authors.forename: Shihai
authors.initials: S
authors.lastname: Luan
authors.affiliation: Department of Radiology, Shanghai Cancer Center, Fudan University, 270 Dongan Road, Shanghai, 200000, China.
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Pathology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai, 200040, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Xiong
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai, 200040, China.
authors.forename: Jianbo
authors.initials: J
authors.lastname: Wen
authors.affiliation: Department of MR Research, GE Healthcare, 1 Huatuo Road, Shanghai, 200000, China.
authors.forename: Jianxun
authors.initials: J
authors.lastname: Qu
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai, 200040, China. GengdaoyingGDY@163.com.
authors.forename: Daoying
authors.initials: D
authors.lastname: Geng
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqi Rd. Middle, Shanghai, 200040, China. yinbo7@163.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Yin
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001488:Basilar Artery / Q000000981:diagnostic imaging*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging*; D008579:Meningioma / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D013113:Spin Labels
chemical_list: D013113:Spin Labels
keywords: Feeding artery; Magnetic resonance imaging; Meningioma; Territorial arterial spin labelling; Time-of-flight magnetic resonance angiography