Article Figures & Data
Figures
- Fig 1.
Relationship between maximum rCBV and angiographic vascularity. Scores are as follows: 0 indicates occult; 1, mild blush; 2, moderate blush; and 3, exuberant. The correlation between the two parameters is shown by the dotted line (r = 0.75; P < .05). The average rCBV and the standard deviation are displayed for each group of angiographic vascularity scores.
- Fig 2.
Images in a 57-year-old patient with left parietal glioblastoma multiforme.
A, Color overlay map reconstructed from pMRI (1000/54) shows marked hyperperfusion of the lesion compared with normal white matter.
B, Para-axial source image of the 3D VIBE acquisition (8.8/4.4; flip angle, 18°) shows a contrast-enhancing tumor with a necrotic center. Note the prominent cerebral vein posterior to the tumor (arrow).
C, Real-time MIP image with 30-mm thickness was reconstructed in position of the image in A and shows the relation of the tumor to the cortical veins and the superior sagittal sinus. The more distal part of the overlying cortical vein (arrow) is not included in the volume. As a result of the MIP algorithm, the tumor appears solid.
D, Coronal source image shows an overlying cortical vein (arrow) in relation to the tumor. The line in parasagittal plane shows the orientation of the image in E.
E, Real-time parasagittal MIP image with 10-mm thickness shows the distal part of the vein in its course (arrows).
F, Venous-phase DSA image obtained with an injection in the left internal carotid artery shows persistent tumor blush (arrow). Compare the display of the overlying cortical vein (arrowheads) to the image in E.
- Fig 3.
Images in a 46-year-old patient with left parasagittal meningioma.
A, Real-time para-axial MIP image with 30-mm thickness shows occlusion (open arrow) of the superior sagittal sinus by the tumor, which has lower signal intensity compared with that of the sinus. Note the extensive collateral cortical veins (solid arrows) draining the frontal part of the sinus.
B, Venous-phase DSA obtained with an injection in the left common carotid artery shows occlusion of the sinus (solid arrow) and prominent frontal collateral cortical veins (open arrow).
- Fig 4.
Sagittal (A) and parasagittal (B) images in a 44-year-old patient with recurrent left parietal glioblastoma multiforme. Sagittal source images lateral to the contrast-enhancing part of the tumor show a cortical vein (large arrow), which blends with the tumor in the medial part (small arrows in B) and can not be distinguished from the tumor. On conventional angiograms (not shown), the vein was patent.
- Fig 5.
Images in a 42-year-old patient with meningioma in right cerebellopontine angle.
A, Real-time para-axial MIP image with 15-mm thickness shows the sigmoid sinus (small arrows) in relation to a meningioma (large arrow), which has signal intensity lower than that of the sinus. No signs of tumor infiltration are depicted.
B, Real-time paracoronal MIP image with 2-mm thickness shows the relation of the posterior fossa arteries to the tumor. Gaps in the basilar artery (large horizontal arrows) and in the right posterior cerebral artery (large vertical arrow) are due to partial volume effects. The proximal superior cerebellar artery is shown with great detail (small arrows).
Tables
- TABLE 1:
Histopathology, contrast enhancement, and comparison of rCBV and vascularity score on DSA images of 22 tumors
Patient No. Histopathology Contrast Enhancement rCBV Vascularity on DSA Image 1 Mixed glioma (low grade) No 1.0 0 2 Mixed glioma (low grade) No 1.1 0 3 Leiomyosarcoma (metastasis) Yes 1.8 1 4 Glioblastoma multiforme Yes 2.4 1 5 Anaplastic astrocytoma Yes 2.6 0 6 Mixed glioma (low grade) No 2.7 0 7 Meningioma Yes 4.1 2 8 Oligodendroglioma (anaplastic) Yes 4.7 1 9 Mixed glioma (anaplastic) Minimal 5.2 0 10 Anaplastic astrocytoma Yes 6.1 2 11 Glioblastoma multiforme Yes 6.2 2 12 Mixed glioma (anaplastic) Yes 7.6 2* 13 Glioblastoma multiforme Minimal 8.6 1 14 Adenocarcinoma (metastasis) Yes 10.3 2 15 Meningioma Yes 11.8 2 16 Glioblastoma multiforme Yes 12.6 2 17 Mixed neuroepithelial tumor (anaplastic) Minimal 13.4 1 18 Glioblastoma multiforme Yes 14.2 2 19 Glioblastoma multiforme Yes 19.5 3* 20 Glioblastoma multiforme Yes 23.6 3* 21 Glioblastoma multiforme Yes 23.8 2 22 Glioblastoma multiforme Yes 23.9 2* * Arteriovenous shunting was present.
Patient No. Location and Side Surgical Approach Vessels Evaluated* Arterial Segments Evaluated 1 Temporal, L Pterional Cortical veins MCA (2–4) 2 Temporal, R Temporal craniotomy Cortical veins None 3 Tectal Stereotactic biopsy Cortical veins, ISS, deep venous system PCA, SCA 4 Temporal, L Stereotactic biopsy Cortical veins MCA (2–4), AchA, Pch 5 Parietal, L Stereotactic biopsy Cortical veins, deep venous system None 6 High parietal, L Parietal craniotomy None 7 Cerebellopontine, L Transpetrosal Cortical veins, sigmoid sinus, SPS PCA, Pcom, SCA, AICA, PICA 8 Frontal, L Frontal craniotomy Cortical veins, ISS, IV, deep venous system ACA (2–4) 9 Parietal, R Posterior frontal craniotomy Cortical veins MCA (2–4) 10 Frontal, R Frontal craniotomy Cortical veins, SSS None 11 Frontal, R Frontal craniotomy Cortical veins, IV ACA (2–4), MCA (2–4) 12 Insula, L Posterior frontal craniotomy Cortical veins MCA (4) 13 Frontal, R Frontal craniotomy Cortical veins ACA (2–4) 14 High parietal, L Frontal craniotomy Cortical veins MCA (4) 15 Parasagittal, L Frontal craniotomy Cortical veins, SSS, IV None 16 Parietal, L Parietal craniotomy Cortical veins, IV None 17 High parietal, L Stereotactic biopsy Cortical veins, ISS, IV ACA (2–4) 18 High occipital, L Superior parietal lobule Cortical veins, SSV, IV ACA (2–4) 19 Parietotemporal, L Posterior temporal craniotomy Cortical veins None 20 Thalamic, L Transcortical Cortical veins, deep venous system AchA, PchA, thalamoperforators 21 Frontal, L Frontal craniotomy Cortical veins, IV ACA (3–4) 22 Occipital, L Occipital craniotomy Cortical veins, SSS, IV None * ISS indicates inferior sagittal sinus; SPS, superior petrosal sinus; IV, interhemispheric veins; and SSS, superior sagittal sinus.
† ACA indicates anterior cerebral artery; Acha, anterior choroidal artery; AICA, anterior inferior cerebellar artery; MCA, middle cerebral artery; PCA, posterior cerebral artery; Pcha, posterior choroidal artery; Pcom, posterior communicating artery; PICA, posterior inferior cerebellar artery; and SCA, superior cerebellar artery.
- TABLE 3:
Scoring table for vascular information provided on VIBE images with DSA as the standard of reference
Vascular Structure No. of Patients Score* All Partial None Total veins 22 17 5 0 Cortical veins 22 18 4 0 Interhemispheric veins 8 7 1 0 Venous sinuses 8 8 0 0 Deep venous system 4 4 0 0 Total arteries 14 0 7 7 * Scores were as follows: All indicated that VIBE imaging provided all of the relevant information; partial, VIBE imaging provided some but not all of the relevant information; and none, VIBE imaging provided none of the relevant information.
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