Digital subtraction angiography (DSA) assesses the necessity of preoperative embolization in meningioma cases but entails complication risks. Previous studies evaluating meningiomas’ angiographic vascularity using perfusion-weighted imaging (PWI) have performed subjective visual assessments, not managing to assess the need for preoperative embolization. We objectively assessed the angiographic stain of meningiomas and examined the usefulness of two parameters of dynamic susceptibility contrast (DSC)-PWI, normalized cerebral blood volume (nCBV) and cerebral blood flow (nCBF), in predicting vascularity and the necessity of preoperative embolization. We retrospectively examined 52 patients who underwent surgery for primary meningioma and preoperative DSA and DSC-PWI. We calculated the normalized luminance (nLum) of the tumor stain in DSA. In 29 meningioma cases with a single feeding artery, we determined the DSC-PWI parameter that correlated with meningioma angiographic vascularity and predicted the necessity of preoperative embolization. We also compared vascularity between meningiomas with single and multiple feeding arteries and between convexity and skull-base meningiomas. nCBF (cut off: 3.66, P = 0.03, area under the curve [AUC] = 0.80) alone could predict the necessity of preoperative embolization and was more significantly correlated with the nLum than nCBV (P = 0.08, AUC = 0.73). Vascularity did not differ between meningiomas with single and multiple feeding arteries; skull-base meningiomas were more vascularized than convexity meningiomas (P = 0.0027). Our objective, quantitative assessments revealed nCBF as the most suitable parameter for evaluating meningioma vascularity. Tumor vascularity assessment using nCBF values and CBF images may aid predicting the necessity of preoperative DSA.

数字减影血管造影 (DSA) 评估脑膜瘤病例术前栓塞的必要性，但存在并发症风险。以前使用灌注加权成像 (PWI) 评估脑膜瘤血管造影血管分布的研究进行了主观视觉评估，未能评估术前栓塞的必要性。我们客观地评估了脑膜瘤的血管造影染色，并检查了动态磁敏感对比 (DSC)-PWI、标准化脑血容量 (nCBV) 和脑血流量 (nCBF) 这两个参数在预测血管分布和术前栓塞必要性方面的有用性。我们回顾性检查了 52 名接受原发性脑膜瘤手术的患者以及术前 DSA 和 DSC-PWI。我们计算了 DSA 中肿瘤染色的归一化亮度 (nLum)。在 29 例具有单一供血动脉的脑膜瘤病例中，我们确定了与脑膜瘤血管造影血管分布相关的 DSC-PWI 参数，并预测了术前栓塞的必要性。我们还比较了单动脉和多动脉供血脑膜瘤之间以及凸面脑膜瘤和颅底脑膜瘤之间的血管分布。nCBF（截断值：3.66，P  = 0.03，曲线下面积 [AUC] = 0.80）单独可以预测术前栓塞的必要性，并且与 nLum 的相关性比 nCBV 更显着（P = 0.08，AUC = 0.73）。具有单供血动脉和多供血动脉的脑膜瘤的血管分布没有差异；颅底脑膜瘤的血管化程度高于凸面脑膜瘤（P  = 0.0027）。我们客观、定量的评估显示 nCBF 是评估脑膜瘤血管分布的最合适的参数。使用 nCBF 值和 CBF 图像评估肿瘤血管分布可能有助于预测术前 DSA 的必要性。