Zhang_edit_Cardiology_book_temp 29/09/2009 10:18 Page 80
Imaging
appraisal. Although meningiomas do have some identifiable imaging meningiomas were significantly greater than those of benign ones
features on conventional MR images, no special feature has been found (p<0.05). The increase in rCBV in the peri-tumoral edema of malignant
to be reliable in predicting tumor grade. Sometimes, the aggressiveness meningiomas might be attributed to tumor invasion and angiogenesis in
of the tumor cannot be accurately characterized even on the basis of the adjacent brain tissue.
29
Our results were also supported by previous
histopathological findings.
24,25
molecular studies of meningiomas, which have shown that FLT1- and
VEGF-positive cells are increased in the endothelium of intratumoral
DSC perfusion MRI has also been used to assess the grade of vessels and are associated with microvascular proliferations in peri-
meningiomas. However, the results of different studies are inconsistent. tumoral brain tissue of anaplastic meningiomas.
30
While Hakyemez et al.
21
found that the rCBV of typical and atypical
meningiomas were statistically different, Zhu et al.
26
found no correlation Conclusion
between rCBV and tumor grade in two malignant and 12 benign DSC perfusion MRI can provide critical information on the vascularity of
meningiomas. In another study Yang et al.
27
found no significant difference meningiomas that is not available with conventional MRI. DSC perfusion
between the rCBV values of seven atypical and 15 benign meningiomas. In MRI measurements are helpful in the pre-operative subtyping and
a series of 33 supratentorial meningiomas (25 benign and eight malignant), grading of meningiomas. Because of the limited patient numbers and
we measured the maximal rCBV (relative to the contralateral normal white the inconsistent results in published papers, perfusion MRI studies of
matter) and corresponding relative MTE (rMTE) in the tumor parenchyma meningioma with larger sample sizes are needed to investigate the
and peri-tumoral edema.
28
While the maximal rCBV derived from the reliability and reproducibility of this new technique before it can be used
maximal blood volume regions in the parenchyma of benign meningiomas as clinical routine. n
was higher than that of malignant meningiomas, the difference between
the two showed no statistical significance. The rMTE in the parenchyma of
Hao Zhang, MD, PhD, is a Professor of Radiology at the
both benign and malignant meningiomas were longer than those of
Shanghai Jiaotong University Affiliated First Hospital, a
normal brain tissue, but there was no statistically significant difference
position he has held since 2005. He is also working on a
between benign and malignant meningiomas. We supposed these findings
PhD at the University of Groningen in The Netherlands.
His major research interests include brain perfusion
could be attributed to the immature and tortuous tumor vessels, which
magnetic resonance imaging (MRI), diagnostic computed
could result in increased leakage of contrast agent from vessels into the
tomography (CT), and MRI of coronary artery and
extravascular space and deceleration of blood flow in the tumor
hepatic tumors. He received his MD from Shandong
University of China in 1988 and his PhD from Fudan
parenchyma. What is interesting in our results is that the maximal rCBV
University of China in 2003.
and corresponding rMTE of peri-tumoral edema of malignant
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80 US NEUROLOGY
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