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