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Peritumoral brain edema in intracranial meningiomas evaluated by dynamic perfusion-weighted MR imaging: a preliminary
Hidemasa Uematsu1, Masayuki Maeda, Harumi Itoh
1Department of Radiology, Fukui Medical University, Fukui, Japan. uematsu@oasis.rad.upenn.edu
Abstract:
Our objective was to semi-quantitatively evaluate the cerebral perfusion in the peritumoral brain edema of meningiomas using dynamic perfusion-weighted MR imaging. Six patients with intracranial meningiomas accompanied by peritumoral brain edema were prospectively examined by perfusion-weighted MR imaging. One patient was examined twice, once before and once 5 months after the surgical resection. The relative regional cerebral blood volume (rrCBV), the relative regional cerebral blood flow (rrCBF), and the relative regional mean transit time (rrMTT) were calculated for peritumoral brain edema and the contralateral white matter. These parameters were compared between peritumoral brain edema and the contralateral white matter. The time-concentration curve of the peritumoral brain edema was less prominent than that of the contralateral white matter, resulting in a significantly lower rrCBV (mean 46%) and rrCBF (mean 45%) in peritumoral brain edema than those of contralateral white matter. The serial perfusion-weighted MR imaging also demonstrated the recovery of these parameters after the removal of meningioma by means of surgical resection. Perfusion-weighted MR imaging can demonstrate significantly decreased rrCBV and rrCBF in peritumoral brain edema compared with those in normal white matter.
Insights
Dynamic perfusion-weighted MR imaging revealed significantly reduced cerebral blood volume and flow in the brain edema surrounding meningiomas. These perfusion deficits, including relative regional cerebral blood volume (rrCBV) and relative regional cerebral blood flow (rrCBF), can recover after surgical tumor removal.
Area of Science:
- Neuroimaging
- Radiology
- Cerebrovascular Physiology
Background:
- Meningiomas are common intracranial tumors.
- Peritumoral brain edema is a frequent complication, affecting neurological function.
- Understanding cerebral perfusion in edema is crucial for diagnosis and management.
Purpose of the Study:
- To semi-quantitatively evaluate cerebral perfusion in the peritumoral brain edema of meningiomas.
- To compare perfusion parameters between edema and normal white matter.
- To assess changes in perfusion after surgical resection.
Main Methods:
- Prospective study of six patients with intracranial meningiomas and peritumoral brain edema.
- Dynamic perfusion-weighted MR imaging was utilized.
- Calculated relative regional cerebral blood volume (rrCBV), relative regional cerebral blood flow (rrCBF), and relative regional mean transit time (rrMTT) in edema and contralateral white matter.
Main Results:
- Peritumoral brain edema showed significantly lower rrCBV (mean 46%) and rrCBF (mean 45%) compared to contralateral white matter.
- Time-concentration curves were less prominent in the edema.
- Serial imaging demonstrated recovery of perfusion parameters after surgical resection.
Conclusions:
- Perfusion-weighted MR imaging effectively demonstrates significantly decreased rrCBV and rrCBF in peritumoral brain edema.
- These findings highlight altered cerebral perfusion dynamics in the vicinity of meningiomas.
- Perfusion-weighted MR imaging can monitor the recovery of cerebral perfusion post-meningioma resection.