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BRAIN

Dynamic Contrast-Enhanced Perfusion MR Imaging Measurements of Endothelial Permeability: Differentiation between Atypical and Typical Meningiomas

Stanley Yanga, Meng Lawa, David Zagzagb, Hope H. Wub, Soonmee Chad, John G. Golfinosc, Edmond A. Knoppa,c and Glyn Johnsona

a Department of Radiology/Division of Neuroradiology, New York University Medical Center, NY
b Department of Pathology/Division of Neuropathology, New York University Medical Center, NY
c Department of Neurosurgery, New York University Medical Center, NY
d Department of Radiology, University of California-San Francisco Medical Center

Address reprint requests to Meng Law, MD, New York University Medical Center, MRI Department, Schwartz Building, Basement HCC, 530 First Avenue, New York, NY 10016

BACKGROUND AND PURPOSE: The measurement of relative cerebral blood volume (rCBV) and the volume transfer constant (Ktrans) by means of dynamic contrast-enhanced (DCE) perfusion MR imaging (pMRI) can be useful in characterizing brain tumors. The purpose of our study was to evaluate the utility of these measurements in differentiating typical meningiomas and atypical meningiomas.

METHODS: Fifteen patients with pathologically confirmed typical meningiomas and seven with atypical meningiomas underwent conventional imaging and DCE pMRI before resection. rCBV measurements were calculated by using standard intravascular indicator dilution algorithms. Ktrans was calculated from the same DCE pMRI data by using a new pharmacokinetic modeling (PM) algorithm. Results were compared with pathologic findings.

RESULTS: Mean rCBV was 8.02 ± 4.74 in the 15 typical meningiomas and 10.50 ± 2.1 in the seven atypical meningiomas. Ktrans was 0.0016 seconds-1 ± 0.0012 in the typical group and 0.0066 seconds-1 ± 0.0026 in the atypical group. The difference in Ktrans was statistically significant (P < .01, Student t test). Other parameters generated with the PM algorithm (plasma volume, volume of the extravascular extracellular space, and flux rate constant) were not significantly different between the two tumor types.

CONCLUSION: DCE pMRI may have a role in the prospective characterization of meningiomas. Specifically, the measurement of Ktrans is of use in distinguishing atypical meningiomas from typical meningiomas.




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