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Research ArticleBRAIN

Dynamic Contrast-Enhanced Perfusion MR Imaging Measurements of Endothelial Permeability: Differentiation between Atypical and Typical Meningiomas

Stanley Yang, Meng Law, David Zagzag, Hope H. Wu, Soonmee Cha, John G. Golfinos, Edmond A. Knopp and Glyn Johnson
American Journal of Neuroradiology September 2003, 24 (8) 1554-1559;
Stanley Yang
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Meng Law
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David Zagzag
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Hope H. Wu
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Soonmee Cha
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John G. Golfinos
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Edmond A. Knopp
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Glyn Johnson
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  • Fig 1.
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    Fig 1.

    Scatterplots of rCBV versus Ktrans.

    A, Grade II (diamonds) versus grade I (squares) meningiomas. The groups are well separated in the permeability measure but not in rCBV.

    B, rCBV versus Ktrans for the two grades. Data points are the mean values. Error bars indicate the SD.

  • Fig 2.
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    Fig 2.

    Photomicrographs (hematoxylin-eosin).

    A, Medium-power image demonstrates tumor cells, which form a lobulated pattern with whorls (arrows) in a typical meningioma (original magnification ×100).

    B, High-power images demonstrates at least three mitotic figures (arrows) in this atypical meningioma (original magnification ×200).

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    Fig 3.

    Pathologically confirmed meningioma (WHO grade I/III).

    A, Axial contrast-enhanced T1-weighted (600/14) MR image.

    B, Axial gradient-echo (1000/54) pMRI image with an rCBV color overlay demonstrates high rCBV throughout the lesion.

    C, Axial gradient-echo (1000/54) axial pMRI image with SD25 depicts a decrease in signal intensity after 25 seconds.

    D, Normalized signal intensity plotted against time for the white matter (squares) and the lesion (triangles). The lines represent the fitted curves derived by using the first-pass PM algorithm. The return to baseline is more rapid in typical meningiomas than in atypical meningiomas.

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    Fig 4.

    Pathologically confirmed atypical meningioma (WHO grade II/III).

    A, Axial contrast-enhanced T1-weighted (600/14) MR image.

    B, Axial gradient-echo (1000/54) pMRI with an rCBV color overlay demonstrates high rCBV throughout the lesion.

    C, Axial gradient-echo (1000/54) pMRI with an SD25 overlay. Red indicates regions of greatest decrease in signal intensity, which are correlated to areas of increased permeability. Qualitatively, this is the best way to distinguish this lesion from that shown in Figure 2.

    D, Normalized signal intensity plotted against time for the white matter (squares) and the lesion (triangles). The lines represent the fitted curve derived by using the first-pass PM algorithm. Increased permeability results in a slower return to baseline.

Tables

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  • rCBV and Ktrans data in 22 patients with typical or atypical meningiomas

    Patient/Age, y/SexrCBV*Ktrans, seconds−1†vp, %‡ve, %§kep‖Location
    Typical meningiomas
     1/27/F9.32.1 × 10−30.873.066.9 × 10−4Right temporal
     2/33/M17.82.8 × 10−410.940.201.4 × 10−3Left lateral ventricle
     3/38/F14.21.8 × 10−39.90.199.1 × 10−3Left frontal
     4/41/F8.71.5 × 10−32.798.191.8 × 10−4Left parietal
     5/42/F4.11.8 × 10−31.231.611.2 × 10−3Right cerebellopontine
     6/42/F15.81.9 × 10−312.30.802.3 × 10−3Right frontal
     7/47/F9.70.9 × 10−53.881.9 × 10−40.47Right parasagittal
     8/47/F5.831.7 × 10−31.630.384.5 × 10−3Right occipital
     9/50/M4.193.0 × 10−35.925.365.8 × 10−4Right frontal
     10/51/F6.543.3 × 10−32.639.633.4 × 10−4Right lateral ventricle
     11/53/F1.999.3 × 10−58.302.3 × 10−24.0 × 10−3Left parietal
     12/55/M2.152.7 × 10−42.115.7 × 10−24.7 × 10−3Left parafalcine
     13/56/F7.53.5 × 10−32.567.564.6 × 10−4Left sphenoid wing
     14/57/F6.942.1 × 10−32.478.092.6 × 10−4Left frontal
     15/59/M5.592.0 × 10−46.783.5 × 10−25.7 × 10−3Right parafalcine
      Mean8.021.6 × 10−34.953.013.4 × 10−2Not applicable
      SD4.741.2 × 10−33.803.661.2 × 10−1Not applicable
    Atypical meningiomas
     16/46/F8.971.1 × 10−21.5713.78.2 × 10−4Right parafalcine
     17/49/F8.26.3 × 10−33.095.171.2 × 10−3Left parasagittal
     18/52/F11.48.2 × 10−39.8036.52.2 × 10−4Left frontal
     19/58/F12.077.1 × 10−312.0232.22.2 × 10−4Right parietal
     20/58/F10.453.2 × 10−312.31.442.2 × 10−3Left frontal
     21/69/F8.524.6 × 10−32.781.682.7 × 10−3Right temporal
     22/79/F13.95.6 × 10−33.5811.494.9 × 10−4Right frontal
      Mean10.506.6 × 10−36.4514.61.1 × 10−3Not applicable
      SD2.12.59 × 10−34.7114.39.9 × 10−4Not applicable
    • * P = .10.

    • † P = .002.

    • ‡ P = .48.

    • § P = .08.

    • ‖ P = .31.

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American Journal of Neuroradiology: 24 (8)
American Journal of Neuroradiology
Vol. 24, Issue 8
1 Sep 2003
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Stanley Yang, Meng Law, David Zagzag, Hope H. Wu, Soonmee Cha, John G. Golfinos, Edmond A. Knopp, Glyn Johnson
Dynamic Contrast-Enhanced Perfusion MR Imaging Measurements of Endothelial Permeability: Differentiation between Atypical and Typical Meningiomas
American Journal of Neuroradiology Sep 2003, 24 (8) 1554-1559;

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Dynamic Contrast-Enhanced Perfusion MR Imaging Measurements of Endothelial Permeability: Differentiation between Atypical and Typical Meningiomas
Stanley Yang, Meng Law, David Zagzag, Hope H. Wu, Soonmee Cha, John G. Golfinos, Edmond A. Knopp, Glyn Johnson
American Journal of Neuroradiology Sep 2003, 24 (8) 1554-1559;
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