Lu Y, Xiong J, Yin B, Wen J, Liu L, Geng D
Department of Radiology, Huashan Hospital, Fudan University, 12(th) Middle Wulumuqi Road, Jingan District, Shanghai, China.
Department of Pathology, Huashan Hospital, Fudan University, 12(th) Middle Wulumuqi Road, Jingan District, Shanghai, China.
Clin Radiol. 2018 Feb;73(2):176-184. doi: 10.1016/j.crad.2017.08.005. Epub 2017 Oct 12.
To evaluate the usefulness of pseudo-continuous arterial spin labelling (pCASL) imaging in grading and differentiating histological subtypes of meningiomas.
In this prospective study, conventional magnetic resonance imaging (MRI) with contrast-enhanced T1-weighted images and pCASL were acquired with a 3 T MRI system before surgery in 125 consecutive patients with suspected meningiomas. Finally, the perfusion parameters were collected from 84 grade I and 23 grade II meningiomas. On the pCASL perfusion map, the mean absolute cerebral blood flow (CBF) values from the meningioma (CBF), peritumoural oedema (CBF), white matter of contralateral centrum semi-ovale (CBF) and normal grey matter (CBF) were calculated. Additionally, the associations of these perfusion parameters with the value of ki-67 index were analysed.
The CBF value correlated negatively with the largest diameter of the tumour, which limited its usage as a reference for ratio calculation. The CBF values of grade II and grade I meningiomas did not differ significantly: 137.36±71.85 ml/min/100 g versus 123.58±135.80 ml/min/100 g (p=0.641). The CBF value was higher for grade II meningioma as than for grade I meningiomas: 30.30±15.56 ml/min/100 g versus 22.33±9.87 ml/min/100 g (p=0.037). The CBF value was highest in angiomatous meningioma and lowest in fibrous meningioma, thus enabling the differentiation of subtypes of meningioma. The CBF value did not correlate with the ki-67 index of meningioma.
The CBF value, rather than the CBF value, from pCASL imaging may serve as a key factor in distinguishing different grades of meningiomas. Moreover, angiomatous meningiomas and fibrous meningiomas can be identified by CBF value.
评估伪连续动脉自旋标记（pCASL）成像在脑膜瘤分级及组织学亚型鉴别中的应用价值。
在这项前瞻性研究中，125例连续的疑似脑膜瘤患者在手术前采用3T磁共振成像（MRI）系统进行常规磁共振成像（包括对比增强T1加权像）及pCASL检查。最终，收集了84例I级和23例II级脑膜瘤的灌注参数。在pCASL灌注图上，计算脑膜瘤（CBF）、瘤周水肿（CBF）、对侧半卵圆中心白质（CBF）及正常灰质（CBF）的平均绝对脑血流量（CBF）值。此外，分析这些灌注参数与ki-67指数值之间的相关性。
CBF值与肿瘤最大直径呈负相关，这限制了其作为比值计算参考的用途。II级和I级脑膜瘤的CBF值差异无统计学意义：分别为137.36±71.85 ml/min/100g和123.58±135.80 ml/min/100g（p=0.641）。II级脑膜瘤的CBF值高于I级脑膜瘤：分别为30.30±15.56 ml/min/100g和22.33±9.87 ml/min/100g（p=0.037）。血管母细胞瘤型脑膜瘤的CBF值最高，纤维型脑膜瘤的CBF值最低，因此能够鉴别脑膜瘤的亚型。CBF值与脑膜瘤的ki-67指数无相关性。
pCASL成像的CBF值而非CBF值，可能是区分不同级别脑膜瘤的关键因素。此外，血管母细胞瘤型脑膜瘤和纤维型脑膜瘤可通过CBF值进行鉴别。
