Research Article

Preoperative Assessment of Blood Vessels and Intratumoral Microbleeds in Brain Tumors Based on a 3D Contrast-Enhanced T₁-Weighted Flow-Sensitive Black-Blood Sequence

Xin Cao PhD

orcid.org/0000-0003-3839-3076

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

National Center for Neurological Disorders, Shanghai, China

Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China

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Kun Lv PhD,

Kun Lv PhD

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

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Xuyang Yin MD,

Xuyang Yin MD

orcid.org/0000-0002-9189-6900

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

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Yunxi Cao MM,

Yunxi Cao MM

College of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, Shandong Province, China

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Siting Xu MD,

Siting Xu MD

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

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Zhe Feng MM,

Zhe Feng MM

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

National Center for Neurological Disorders, Shanghai, China

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Yan Han MD,

Yan Han MD

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

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Ye Tang MM,

Ye Tang MM

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

National Center for Neurological Disorders, Shanghai, China

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Daoying Geng PhD,

Daoying Geng PhD

orcid.org/0000-0002-3585-6883

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

National Center for Neurological Disorders, Shanghai, China

Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China

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Jun Zhang PhD,

Corresponding Author

Jun Zhang PhD

[email protected]

orcid.org/0000-0003-1849-9199

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

National Center for Neurological Disorders, Shanghai, China

Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China

Address reprint requests to: J.Z., Department of Radiology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai 200040, China. E-mail: [email protected]

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Xin Cao PhD,

Xin Cao PhD

orcid.org/0000-0003-3839-3076

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

National Center for Neurological Disorders, Shanghai, China

Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China

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Kun Lv PhD,

Kun Lv PhD

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

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Xuyang Yin MD,

Xuyang Yin MD

orcid.org/0000-0002-9189-6900

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

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Yunxi Cao MM,

Yunxi Cao MM

College of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, Shandong Province, China

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Siting Xu MD,

Siting Xu MD

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

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Zhe Feng MM,

Zhe Feng MM

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

National Center for Neurological Disorders, Shanghai, China

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Yan Han MD,

Yan Han MD

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

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Ye Tang MM,

Ye Tang MM

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

National Center for Neurological Disorders, Shanghai, China

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Daoying Geng PhD,

Daoying Geng PhD

orcid.org/0000-0002-3585-6883

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

National Center for Neurological Disorders, Shanghai, China

Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China

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Jun Zhang PhD,

Corresponding Author

Jun Zhang PhD

[email protected]

orcid.org/0000-0003-1849-9199

Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China

National Center for Neurological Disorders, Shanghai, China

Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China

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First published: 30 August 2022

https://doi.org/10.1002/jmri.28415

Citations: 1

Xin Cao, Kun Lv, and Xuyang Yin contributed equally to this study.

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Abstract

Background

Three-dimensional (3D) contrast-enhanced T₁-weighted flow-sensitive black-blood (CE-T₁WI FSBB) is a newly developed black blood sequence by adding motion probing gradient pulses to gradient echo (GRE) sequences, which has important value for the preoperative assessment of tumor brain blood supply vessels and intratumoral microbleeds.

Purpose

To compare 3D CE-T₁WI FSBB and 3D contrast-enhanced fast spin echo (FSE) sequence for T₁WI for preoperative assessment of blood vessels and microbleeds in brain tumors and to investigate the correlation between visible vessels and microbleeds.

Study type

Prospective.

Subjects

One hundred and seventy-five patients with brain tumors, 65 were male, 110 were female. Including histologically confirmed 73 meningiomas, 23 schwannomas, 20 gliomas, 7 hemangioblastomas, 5 metastases, 2 lymphomas, 2 hemangiopericytomas, 2 germ cell tumors, 1 craniopharyngioma, and 1 cholesteatoma.

Field Strength/Sequence

A 3-T, CE-T₁WI FSBB, GRE; 3-T, CE-T₁WI, FSE.

Assessment

Three neuroradiologists counted the number of intratumoral vessels on CE-T₁WI and CE-T₁WI FSBB images separately, and they counted the number of intratumoral microbleeds on CE-T₁WI FSBB images. Brain tumors were classified into grade I, grade II, and grade IV according to the World Health Organization (WHO) grading. Differences in the ability of CE-T₁WI FSBB and CE-T₁WI to display intratumoral vessels were compared. The mean counts of three observers were used to study the correlation between vessels and microbleeds.

Statistical Tests

Two-way random intraclass correlation coeficient (ICC) was used for inter-reader agreement regarding intratumoral vessel and microbleed counts, and the linear regression analysis (with F-test) was used to study the correlation between intratumoral vessels and microbleeds based on CE-T₁WI FSBB (α = 0.05).

Results

Inter-reader agreements for intratumoral vessel count on CE-T₁WI (ICC = 0.93) and CE-T₁WI FSBB (ICC = 0.92), and the agreement for intratumoral microbleed count on CE-T₁WI FSBB (ICC = 0.99) were excellent. There were statistically significant differences in intratumoral vessel counts between CE-T₁WI and CE-T₁WI FSBB using Mann–Whitney U -test: image readers could identify more intratumoral vessels on CE-T₁WI FSBB images, particularly for meningiomas, schwannomas, gliomas, and WHO grade I tumors. The number of intratumoral vessels had a significant positive effect on the number of intratumoral microbleeds (microbleeds = 5.024 + 1.665 × vessels; F = 11.51).

Data Conclusion

More intratumoral vessels could potentially be identified using a 3D CE-T₁WI FSBB sequence compared to a CE-T₁WI sequence, and the number of intratumoral vessels showed a positive linear relationship with the number of intratumoral microbleeds, which might suggest that brain tumors with rich blood supply were more prone to intratumoral microbleeds.

Evidence Level

Technical Efficacy

Stage 3

References

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Citing Literature

Volume57, Issue5

May 2023

Pages 1543-1551

Preoperative Assessment of Blood Vessels and Intratumoral Microbleeds in Brain Tumors Based on a 3D Contrast-Enhanced T₁-Weighted Flow-Sensitive Black-Blood Sequence

Abstract

Background

Purpose

Study type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Evidence Level

Technical Efficacy

References

Citing Literature

References

Information

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Preoperative Assessment of Blood Vessels and Intratumoral Microbleeds in Brain Tumors Based on a 3D Contrast-Enhanced T1-Weighted Flow-Sensitive Black-Blood Sequence

Abstract

Background

Purpose

Study type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Evidence Level

Technical Efficacy

References

Citing Literature

References

Related

Information

Preoperative Assessment of Blood Vessels and Intratumoral Microbleeds in Brain Tumors Based on a 3D Contrast-Enhanced T₁-Weighted Flow-Sensitive Black-Blood Sequence