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European Radiology
Published in: European Radiology 10/2017

01-10-2017 | Oncology

Evaluation of the applicability of territorial arterial spin labeling in meningiomas for presurgical assessments compared with 3-dimensional time-of-flight magnetic resonance angiography

Authors: Yiping Lu, Shihai Luan, Li Liu, Ji Xiong, Jianbo Wen, Jianxun Qu, Daoying Geng, Bo Yin

Published in: European Radiology | Issue 10/2017

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Abstract

Objectives

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).

Conclusion

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.

Key Points

• 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.
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Metadata
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
Authors
Yiping Lu
Shihai Luan
Li Liu
Ji Xiong
Jianbo Wen
Jianxun Qu
Daoying Geng
Bo Yin
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4760-9

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