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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 23:1767-1774, November-December 2002
© 2002 American Society of Neuroradiology

BRAIN

Preoperative Assessment of Intracranial Tumors with Perfusion MR and a Volumetric Interpolated Examination: A Comparative Study with DSA

Stephan G. Wetzel^a, Soonmee Cha^a, Meng Law^a, Glyn Johnson^a, John Golfinos^b, Peter Lee^a and Peter Kim Nelson^a

^a Department of Radiology, New York University Medical Center, NY
^b Department of Neurosurgery, New York University Medical Center, NY

Address reprint requests to Meng Law, Department of Radiology, New York University Medical Center, MRI-Basement, Schwartz Bldg, 530 First Ave, New York, NY 10016

BACKGROUND AND PURPOSE: In evaluating intracranial tumors, a safe low-cost alternative that provides information similar to that of digital subtraction angiography (DSA) may be of interest. Our purpose was to determine the utility and limitations of a combined MR protocol in assessing (neo-) vascularity in intracranial tumors and their relation to adjacent vessels and to compare the results with those of DSA.

METHODS: Twenty-two consecutive patients with an intracranial tumor who underwent preoperative stereoscopic DSA were examined with contrast-enhanced dynamic T2*-weighted perfusion MR imaging followed by a T1-weighted three-dimensional (3D) MR study (volumetric interpolated brain examination [VIBE]). The maximum relative cerebral blood volume (rCBV) of the tumor was compared with tumor vascularity at DSA. Critical vessel structures were defined in each patient, and VIBE images of these structures were compared with DSA findings. For full exploitation of the 3D data sets, maximum-intensity projection algorithms reconstructed in real time with any desired volume and orientation were used.

RESULTS: Tumor blush scores at DSA were significantly correlated with the rCBV measurements (r = 0.75; P < .01, Spearman rank correlation coefficient). In 17 (77%) patients, VIBE provided all relevant information about the venous system, whereas information about critical arteries were partial in 50% of the cases and not relevant in the other 50%.

CONCLUSION: A fast imaging protocol consisting of perfusion MR imaging and a volumetric MR acquisition provides some of the information about tumor (neo-) vascularity and adjacent vascular anatomy that can be obtained with conventional angiography. However, the MR protocol provides insufficient visualization of distal cerebral arteries.

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