Scholarlink

Purpose <p>The deep location and choroidal arterial supply of intraventricular meningiomas (IVMs) make preoperative vascular assessment critical for anticipating surgical complexity and hemorrhagic risk, especially in larger tumors. While arterial spin-labeling (ASL)-MRI reliably quantifies tumor blood flow in typical dural meningiomas, IVM perfusion features and heterogeneity relative to other intraventricular lesions remain poorly characterized. We hypothesized that ASL-derived perfusion metrics do not scale proportionally with increasing tumor size and that focal perfusion heterogeneity distinguishes IVMs from non-IVM intraventricular lesions.</p> Methods <p>We retrospectively analyzed 20 patients with untreated IVMs and 8 with non-IVM intraventricular hyperperfused masses. We calculated tumor volumes and extracted perfusion values from ASL-cerebral blood flow (CBF) maps from diagnostic-quality ASL-MRI to derive normalized peak and mean tumor CBF, a “hyperperfusion index”, and a volume-normalized “heterogeneity index”. Associations between tumor volume and perfusion metrics were tested using Pearson and Spearman correlation. Excess heterogeneity relative to non-IVM lesions was quantified using log-scale residuals and compared using Mann-Whitney testing.</p> Results <p>IVM volume correlated positively with normalized peak CBF (<i>r</i> = 0.61, <i>p</i> = 0.005) and hyperperfusion index (<i>r</i> = 0.64, <i>p</i> = 0.004) but not mean CBF. These associations remained significant under rank-based analysis. Compared with non-IVMs, IVMs demonstrated significantly greater perfusion heterogeneity after adjusting for tumor size (<i>p</i> = 0.025). Larger tumors frequently exhibited focal ASL hyperintense perfusion “hotspots.”</p> Conclusion <p>IVMs exhibit disproportionate focal perfusion heterogeneity and size-dependent increases in peak perfusion not reflected in mean perfusion measures. ASL enables noninvasive characterization of vascular intensity and spatial heterogeneity, providing clinically relevant insight into angiogenic remodeling and improving preoperative vascular risk assessment and stratification.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Intraventricular meningiomas show size-dependent increases in peak ASL-MRI perfusion reflecting vascular heterogeneity

  • 期刊论文

  • 发表日期：

    2026年4月3日

查看全文
  • Christopher J. Shin,
  • Abdelkader Mahammedi,
  • Tarik F. Massoud

摘要

Purpose

The deep location and choroidal arterial supply of intraventricular meningiomas (IVMs) make preoperative vascular assessment critical for anticipating surgical complexity and hemorrhagic risk, especially in larger tumors. While arterial spin-labeling (ASL)-MRI reliably quantifies tumor blood flow in typical dural meningiomas, IVM perfusion features and heterogeneity relative to other intraventricular lesions remain poorly characterized. We hypothesized that ASL-derived perfusion metrics do not scale proportionally with increasing tumor size and that focal perfusion heterogeneity distinguishes IVMs from non-IVM intraventricular lesions.

Methods

We retrospectively analyzed 20 patients with untreated IVMs and 8 with non-IVM intraventricular hyperperfused masses. We calculated tumor volumes and extracted perfusion values from ASL-cerebral blood flow (CBF) maps from diagnostic-quality ASL-MRI to derive normalized peak and mean tumor CBF, a “hyperperfusion index”, and a volume-normalized “heterogeneity index”. Associations between tumor volume and perfusion metrics were tested using Pearson and Spearman correlation. Excess heterogeneity relative to non-IVM lesions was quantified using log-scale residuals and compared using Mann-Whitney testing.

Results

IVM volume correlated positively with normalized peak CBF (r = 0.61, p = 0.005) and hyperperfusion index (r = 0.64, p = 0.004) but not mean CBF. These associations remained significant under rank-based analysis. Compared with non-IVMs, IVMs demonstrated significantly greater perfusion heterogeneity after adjusting for tumor size (p = 0.025). Larger tumors frequently exhibited focal ASL hyperintense perfusion “hotspots.”

Conclusion

IVMs exhibit disproportionate focal perfusion heterogeneity and size-dependent increases in peak perfusion not reflected in mean perfusion measures. ASL enables noninvasive characterization of vascular intensity and spatial heterogeneity, providing clinically relevant insight into angiogenic remodeling and improving preoperative vascular risk assessment and stratification.