Can 3T MR Angiography Replace DSA for the Identification of Arteries Feeding Intracranial Meningiomas?

Abstract

BACKGROUND AND PURPOSE:For identifying the arterial feeders of meningiomas, the usefulness of 3D TOF MRA at 3T has not been systematically investigated. This study was intended to assess whether unenhanced 3D TOF MRA at 3T can replace DSA for the identification of arteries feeding intracranial meningiomas and whether it is useful for assessing their dural attachment.

Assessment of Angiographic Vascularity of Meningiomas with Dynamic Susceptibility Contrast-Enhanced Perfusion-Weighted Imaging and Diffusion Tensor Imaging

“…It has been reported that the information about vascular supply of meningiomas could be obtained with arterial spin-labeling, regional perfusion imaging, and MRA. 3,4 Our results show that CBV and FA may complement arterial spin-labeling, regional perfusion imaging, and MRA by providing information about the degree of angiographic vascularity and may enhance the role of MR imaging in the preoperative assessment of meningiomas. Although the presence intratumoral vessels seen as flow voids on T2WI or enhancing vascular structures on postcontrast T1WI as well as the intensity of contrast enhancement may help to assess the vascularity of meningiomas, these imaging features cannot predict the angiographic vascularity of the tumor in a quantitative manner.…”

“…3 MRA, on the other hand, helped to identify the arterial branches primarily supplying the meningiomas. 4 To our knowledge, there is no report on the use of quantitative MR techniques to predict the degree of angiographic vascularity of meningiomas.…”

Microsurgical treatment of parafalcine meningiomas: a retrospective study of 126 cases

“…We believe that: 1) preoperative DSA should be performed to determine the origin of arterial supply and situation of blood supply of tumor, and compression of pericallosal artery should be performed, simultaneously, the supplying artery should be embolized to facilitate the reduction of intraoperative hemorrhage and improve surgical safety and thorough removal, the surgery may be performed within 3–7 days after embolization;8 2) it is crucial to ensure the surgical field is kept at the highest position to facilitate the venous return and reduction of intracranial pressure; 3) before the dura mater is cut open, a fast intravenous drip of 250 mL of 20% mannitol should be administered, if the intracranial pressure has not improved significantly, proper hyperventilation should be used; 4) the cerebral dura mater should be separated carefully by stripper when the bone flap is turned over, the rupture of dura mater should be avoided; the sagittal sinus margin should be approached adequately while the sagittal sinus should be protected in order to avoid hemorrhage when the cerebral dura mater is being cut open near the midline; 5) as for the supplying vessel of the tumor, the principle that the artery should be treated first and then the vein should be blocked, should be followed according to the arterial distribution shown by DSA, otherwise, the patient is at a risk of fast congestion and expansion of tumor and then massive hemorrhage. One hundred and twenty-six patients with parafalcine meningiomas in this group were treated with the previously mentioned measures, with an average blood loss of only 410 mL.…”

Diagnostic value of 3D time-of-flight MRA in trigeminal neuralgia

“…In clinical practice, 3D-TOF-MRA is effective for TN diagnosis, providing improved visualization of the relationship between the trigeminal nerve and vessels [15], including the site of compression [16]. Compared with conventional imaging techniques, 3D-TOF-MRA offers better blood-to-background contrast and higher spatial resolution and it is an inexpensive, sensitive, safe and accurate imaging technique [7,17]. However, 3D-TOF-MRA is still an emerging technique and flow artifacts and longer image acquisition times are inherent disadvantages [14,18].…”