Abstract
BackgroundIntracranial meningiomas may be amenable to presurgical embolization to reduce bleeding complications. Detailed information usually obtained by digital subtraction angiography (DSA) on the contribution of blood supply from internal and external carotid artery branches is required to prevent non-target embolization and is helpful for pre-surgical planning.PurposeTo investigate the contribution of the feeding vasculature to intracranial meningiomas with superselective arterial spin labelling (sASL) as an alternative to DSA.Material and methodsConsecutive patients presenting for meningioma resection were prospectively included. sASL perfusion images acquired on a clinical 3T MRI scanner were independently rated by two readers. Contribution of the external carotid artery (ECA), internal carotid artery (ICA) and vertebral/basilar artery (VA/BA) was rated as none, <50% or >50%. Correlation of sASL was performed in two patients undergoing DSA.Results32 patients (61 ± 13 years) harboring 42 meningiomas could be included. sASL was technically successful in all patients. 19 meningiomas had ICA dominant supply, 19 had ECA dominant supply. One meningioma had mixed supply and in three meningiomas a perfusion signal could not be detected. While exclusive unilateral ECA supply was common (n = 14) and exclusive unilateral ICA was rare (n = 4), mixed supply from multiple vessels (n = 20) was a frequent finding. Interrater agreement was substantial (κ = 0.73). Agreement with DSA was perfect within our predefined categories.ConclusionsASL is able to identify the presence and extent of the feeding vasculature in intracranial meningiomas.
Highlights
Meningiomas are the most common benign tumors of the central nervous system
The funder provided support in the form of salaries for Michael Helle, but did not have any additional role in the study design, data collection and analysis, decision to publish, or patients (61 ± 13 years) harboring 42 meningiomas could be included. superselective arterial spin labelling (sASL) was technically successful in all patients. 19 meningiomas had internal carotid artery (ICA) dominant supply, 19 had external carotid artery (ECA) dominant supply
This is usually obtained by digital subtraction angiography (DSA)
Summary
Meningiomas are the most common benign tumors of the central nervous system. malignant meningiomas and malignant transformation are rare, space occupying or symptomatic meningiomas may require resection [1]. Meningiomas are richly vascularized lesions and are amenable to presurgical embolization to reduce bleeding complications [2]. Detailed information on the contribution of blood supply from internal and external carotid artery branches are helpful for pre-surgical planning and required to prevent non-target embolization [3]. Intracranial meningiomas may be amenable to presurgical embolization to reduce bleeding complications. Detailed information usually obtained by digital subtraction angiography (DSA) on the contribution of blood supply from internal and external carotid artery branches is required to prevent non-target embolization and is helpful for pre-surgical planning. To investigate the contribution of the feeding vasculature to intracranial meningiomas with superselective arterial spin labelling (sASL) as an alternative to DSA
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