• Dhruv Parikh, Fardad T Afshari, Khaled Sherlala, Shahzada Ahmed, and Amjad Shad.
• Department of Neurosurgery, University Hospital of Coventry and Warwickshire, Coventry, United Kingdom.
• World Neurosurg. 2020 Oct 1; 142: e407-e412.

BackgroundDifferentiating sellar region meningiomas from pituitary adenomas on standard magnetic resonance imaging (MRI) sequences can be difficult. Arterial spin labeling (ASL) is a noninvasive technique of magnetic resonance perfusion imaging. The range of applications of ASL in neurosurgery has increased, and the information provided can be unique and complementary to other MRI sequences. Here we investigate the utility of ASL MRI in differentiating between sellar region meningiomas and pituitary adenomas.MethodsThis was a retrospective comparison of quantitative assessments on absolute and normalized tumor blood flow in histologically proven meningiomas versus pituitary adenomas.ResultsA total of 15 patients with sellar region lesions were identified, including 9 meningiomas and 6 pituitary adenomas. Mean absolute tumor blood flow and normalized tumor blood flow were significantly higher in meningiomas (131 mL/100 g/min and 2.22) than adenomas (47 mL/100 g/min and 0.92; P < 0.05).ConclusionsASL MRI is a useful adjunct sequence in differentiating sellar region meningiomas, which exhibit high perfusion, from pituitary adenomas, which exhibit relatively low perfusion.Copyright © 2020 Elsevier Inc. All rights reserved.

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