Journal of neuroradiology = Journal de neuroradiologie · 2019
Can we predict intraoperative blood loss in meningioma patients? Application of dynamic susceptibility contrast-enhanced magnetic resonance imaging.
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Kang Yeonah, Wei Kuo-Chen, Toh Cheng Hong
Аннотация
PURPOSE: To evaluate the potential of quantitative dynamic susceptibility contrast (DSC) perfusion MR imaging parameters as imaging biomarkers for predicting intraoperative blood loss in meningioma.
METHODS: Fifty-one non-embolized meningioma patients who had undergone preoperative DSC perfusion MR imaging were retrospectively included. The corrected relative cerebral blood volume (rCBV) and leakage coefficient (K2) of the entire enhanced tumor were obtained using leakage correction. Tumor volume, location, grade, and other clinical variables, were also analyzed. To investigate the vascularity and vascular permeability of meningiomas, and their correlation with predicting estimated blood loss (EBL) using preoperative DSC perfusion MR imaging, the authors proposed an index reflecting the inherent tendency of meningiomas to bleed after controlling volume (i.e., EBL/cm3). Simple regression was performed to identify predictors of EBL/cm3; subsequently, the relevant variables included in the stepwise multiple linear regression.
RESULTS: On univariate analysis, EBL/cm3 was correlated with rCBV (r=0.677; P<0.001), K2 (r=0.294; P=0.036), and tumor volume (r=-0.312, P=0.026). EBL/cm3 was not correlated with age (P=0.873), sex (P=0.404), tumor location (P=0.327), or histological grade (P=0.230). On multiple linear regression, rCBV (β=0.663 [0.463-0.864], B=1.293 [0.903-1.684; P<0.001) and K2 (β=0.260 [0.060-0.460], B=2.277 [0.523-4.031], P=0.012), were the only independent predictors of EBL/cm3.
CONCLUSION: The rCBV and K2 derived from DSC perfusion MR imaging in meningiomas may serve as feasible tools for clinicians to predict intraoperative blood loss and facilitate surgical planning.
METHODS: Fifty-one non-embolized meningioma patients who had undergone preoperative DSC perfusion MR imaging were retrospectively included. The corrected relative cerebral blood volume (rCBV) and leakage coefficient (K2) of the entire enhanced tumor were obtained using leakage correction. Tumor volume, location, grade, and other clinical variables, were also analyzed. To investigate the vascularity and vascular permeability of meningiomas, and their correlation with predicting estimated blood loss (EBL) using preoperative DSC perfusion MR imaging, the authors proposed an index reflecting the inherent tendency of meningiomas to bleed after controlling volume (i.e., EBL/cm3). Simple regression was performed to identify predictors of EBL/cm3; subsequently, the relevant variables included in the stepwise multiple linear regression.
RESULTS: On univariate analysis, EBL/cm3 was correlated with rCBV (r=0.677; P<0.001), K2 (r=0.294; P=0.036), and tumor volume (r=-0.312, P=0.026). EBL/cm3 was not correlated with age (P=0.873), sex (P=0.404), tumor location (P=0.327), or histological grade (P=0.230). On multiple linear regression, rCBV (β=0.663 [0.463-0.864], B=1.293 [0.903-1.684; P<0.001) and K2 (β=0.260 [0.060-0.460], B=2.277 [0.523-4.031], P=0.012), were the only independent predictors of EBL/cm3.
CONCLUSION: The rCBV and K2 derived from DSC perfusion MR imaging in meningiomas may serve as feasible tools for clinicians to predict intraoperative blood loss and facilitate surgical planning.