PURPOSE Hypervascular vestibular schwannomas (HVSs) are a type of the vestibular schwannomas (VSs) that are extremely difficult to remove. We examined whether HVSs can be predicted by using arterial spin labeling (ASL) imaging. METHODS A total of 103 patients with VSs underwent ASL imaging and digital subtraction angiography (DSA) before surgery. Regional cerebral blood flow (CBF) of gray matter and regional tumor blood flow (TBF) were calculated from ASL imaging, and we defined the ratio of TBF to CBF as the relative TBF (rTBF = TBF/CBF). Angiographic vascularity was evaluated by DSA, and clinical vascularity was evaluated by the degree of intraoperative tumor bleeding. Based on the angiographic and clinical vascularity, the VSs were divided into two categories: HVS and non-HVS. We compared rTBF with angiographic and clinical vascularities, retrospectively. RESULTS The mean rTBFs of angiographic non-HVSs and HVSs were 1.29 and 2.58, respectively (p < 0.0001). At a cutoff value of 1.55, the sensitivity and specificity were 93.9% and 72.9%, respectively. The mean rTBFs of clinical non-HVS and HVSs were 1.45 and 2.22, respectively (p = 0.0002). At a cutoff value of 1.55, the sensitivity and specificity were 79.4% and 66.7%, respectively. CONCLUSION The rTBF calculated from ASL imaging correlates well with tumor vascularity and may be useful for predicting HVSs before surgery.

中文翻译：

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动脉自旋标记成像与前庭神经鞘瘤的血管造影和临床血管形成有关。

目的高血管前庭神经鞘瘤（HVS）是一种非常难以去除的前庭神经鞘瘤（VSs）。我们检查了是否可以通过使用动脉自旋标记（ASL）成像预测HVS。方法共有103例VS患者在手术前接受了ASL成像和数字减影血管造影（DSA）。通过ASL成像计算灰质的局部脑血流量（CBF）和区域肿瘤血流量（TBF），我们将TBF与CBF之比定义为相对TBF（rTBF = TBF / CBF）。通过DSA评估血管造影血管，通过术中肿瘤出血程度评估临床血管。根据血管造影和临床血管分布，将VS分为两类：HVS和非HVS。我们将rTBF与血管造影和临床血管造影进行了比较，追溯地。结果血管造影非HVS和HVS的平均rTBF分别为1.29和2.58（p <0.0001）。截断值为1.55时，敏感性和特异性分别为93.9％和72.9％。临床非HVS和HVS的平均rTBF分别为1.45和2.22（p = 0.0002）。截断值为1.55时，敏感性和特异性分别为79.4％和66.7％。结论从ASL成像计算得出的rTBF与肿瘤血管的相关性很好，可能有助于预测术前HVS。截断值为1.55时，敏感性和特异性分别为79.4％和66.7％。结论从ASL成像计算出的rTBF与肿瘤血管的相关性很好，可能有助于预测手术前的HVS。截断值为1.55时，敏感性和特异性分别为79.4％和66.7％。结论从ASL影像计算得出的rTBF与肿瘤血管的相关性很好，可能有助于预测术前的HVS。