Purpose To evaluate the ability of intravenous (IV) and intraarterial (IA) MR perfusion to characterize meningioma blood supply.
Materials and methods Institutional review board approval and informed consent were obtained for this prospective, HIPAA-compliant study. Studies were performed in a suite comprised of an x-ray angiography unit and 1.5T MR scanner that permitted intraprocedural patient movement between the imaging modalities. Twelve patients underwent IV and IA T2* dynamic susceptibility contrast MR perfusion immediately prior to x-ray-guided meningioma embolization. DSA was used to characterize regional arterial supply to the tumor as ECA dural, ICA dural or pial. MR perfusion data ROIs were analyzed in regions with different vascular supply to extract peak height, full-width at half-maximum (FWHM), and time to 50% and 60% signal recovery (TSR50–60%). One-sided t-tests were used to analyze ROI data.
Results Arterial supply was ECA dural (n = 11), ICA dural (n = 4) or pial (n = 3) based on DSA. No differences in IA MR perfusion peak height (p = 0.66), FWHM (p = 0.78), TSR50% (p = 0.41), and TSR60% (p = 0.55) were found between ECA and ICA dural ROIs. ICA and ECA dural ROIs were combined and compared to pial ROIs. Pial ROIs demonstrated shorter FWHM (t = 7.9s vs. 16.9s, p = 0.025), TSR50% (t = 5.2s vs. 12.6s, p = 0.043), and TSR60% (t = 6.5s vs. 16.4s, p = 0.046). There was no difference in peak height. For IV MR perfusion, no differences were found between ECA and ICA dural ROIs and dural and pial ROIs.
Conclusions IA MR perfusion measures can identify ICA-derived pial supply not amenable to embolization, although IV MR perfusion imaging may not be sensitive enough.
Disclosures S. Hetts: 1; C; NIH-NIBIB, NIH-NCI, Siemens, Penumbra, Stryker, MicroVention Terumo. 2; C; Silk Road Medical, Medina Medical, Stryker, Penumbra. 4; C; ChemoFilter, Medina Medical. 5; C; UCSF. M. Lum: None. A. Martin: None. D. Cooke: None. P. Lillaney: None. M. Amans: None. F. Settecase: None. A. Nicholson: None. C. Dowd: None. V. Halbach: None. R. Higashida: None. M. McDermott: None. D. Saloner: 1; C; NIH-NCI.
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