• Masahiko Wanibuchi, Katsuya Komatsu, Yukinori Akiyama, Takeshi Mikami, Satoshi Iihoshi, Kei Miyata, and Nobuhiro Mikuni.
• Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
• World Neurosurg. 2016 Sep 1; 93: 237-45.

BackgroundMeningioma is a hypervascular tumor of the central nervous system. Angiographic disappearance of tumor blush after preoperative feeder embolization allows qualitative, but not quantitative, assessment of flow reduction. Pseudocontinuous arterial spin labeling (PCASL), which has evolved from magnetic resonance imaging techniques, allows noninvasive measurement of cerebral blood flow (CBF) using water protons in the arterial blood flow.ObjectiveWe applied PCASL for assessment of blood flow in meningioma and its reduction on preoperative embolization.MethodsForty-one consecutive patients (11 males, 30 females) with histologically proven meningioma were evaluated by PCASL. Quantitative assessment by an absolute value of tumor blood flow (TBF) and a relative value of tumor vascular index (tVI; calculated as TBF divided by CBF) were calculated. In 8 cases, in which preoperative embolization was achieved, flow reduction rate was evaluated.ResultsTBF of meningiomas, 155.8 mL/100 g·min(-1) on average, was 2.6 times higher than CBF, 59.9 mL/100 g·min(-1) (P < 0.001). Patients who underwent feeder embolization showed statistically greater flow reduction rate, which was calculated as 42.7% (P < 0.05). Mean tVI before embolization was 4.1, which was reduced to 2.1 after embolization.ConclusionPCASL could yield quantitative assessment of blood flow in meningioma including flow reduction rate in cases of feeder embolization.Copyright © 2016 Elsevier Inc. All rights reserved.

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