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
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FIG 1. Scatterplots of rCBV versus Ktrans.
A, Grade II (diamonds) versus grade I (squares) meningiomas. The groups are well separated in the permeability measure but not in rCBV.
B, rCBV versus Ktrans for the two grades. Data points are the mean values. Error bars indicate the SD.
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FIG 2. Photomicrographs (hematoxylin-eosin).
A, Medium-power image demonstrates tumor cells, which form a lobulated pattern with whorls (arrows) in a typical meningioma (original magnification x100).
B, High-power images demonstrates at least three mitotic figures (arrows) in this atypical meningioma (original magnification x200).
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FIG 3. Pathologically confirmed meningioma (WHO grade I/III).
A, Axial contrast-enhanced T1-weighted (600/14) MR image.
B, Axial gradient-echo (1000/54) pMRI image with an rCBV color overlay demonstrates high rCBV throughout the lesion.
C, Axial gradient-echo (1000/54) axial pMRI image with SD25 depicts a decrease in signal intensity after 25 seconds.
D, Normalized signal intensity plotted against time for the white matter (squares) and the lesion (triangles). The lines represent the fitted curves derived by using the first-pass PM algorithm. The return to baseline is more rapid in typical meningiomas than in atypical meningiomas.
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FIG 4. Pathologically confirmed atypical meningioma (WHO grade II/III).
A, Axial contrast-enhanced T1-weighted (600/14) MR image.
B, Axial gradient-echo (1000/54) pMRI with an rCBV color overlay demonstrates high rCBV throughout the lesion.
C, Axial gradient-echo (1000/54) pMRI with an SD25 overlay. Red indicates regions of greatest decrease in signal intensity, which are correlated to areas of increased permeability. Qualitatively, this is the best way to distinguish this lesion from that shown in Figure 2.
D, Normalized signal intensity plotted against time for the white matter (squares) and the lesion (triangles). The lines represent the fitted curve derived by using the first-pass PM algorithm. Increased permeability results in a slower return to baseline.
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