Differentiation between ICA and ECA Feeder Distributions in Meningioma Using MR Perfusion Original Image.

OBJECTIVE

Preoperative information regarding tumor feeder distribution is important in meningioma surgery. We aimed to examine the relationship between the contrast-enhancement pattern in meningioma on magnetic resonance (MR) perfusion images and the feeder pattern.

METHODS

The subjects were 21 patients diagnosed with meningioma who underwent MR perfusion imaging between 2017 and 2020.

RESULTS

The distribution of feeders from the internal carotid artery (ICA) system or external carotid artery (ECA) system within the tumor based on angiograms was compared with that in areas of enhancement on original MR perfusion images in seven of 21 patients who underwent cerebral angiography. The aspect ratios of tumors, which was defined as the ratio of the area of contrast enhancement to the length of the enhanced area in contact with the tumor margin on the early-phase MR perfusion images, supplied by the ICA (pial feeder pattern) and ECA (dural feeder pattern) systems were 0.12 ± 0.11 and 7.21 ± 4.99 (mean ± standard deviation), respectively ( < 0.0001). MR perfusion imaging in all 21 patients revealed higher frequency of the pial feeder pattern in patients with peritumoral edema ( = 0.0009).

CONCLUSION

The distribution of pial and dural feeders within a meningioma could be distinguished by the aspect ratio based on original MR perfusion images.