Dynamic contrast-enhanced magnetic resonance perfusion compared with digital subtraction angiography for the evaluation of extradural spinal metastases: A pilot study Journal Article

  

Authors:	Mazura, J. C.; Karimi, S.; Pauliah, M.; Banihashemi, M. A.; Gobin, Y. P.; Bilsky, M. H.; Patsalides, A.
Article Title:	Dynamic contrast-enhanced magnetic resonance perfusion compared with digital subtraction angiography for the evaluation of extradural spinal metastases: A pilot study
Abstract:	Study Design.: This was a retrospective study comparing dynamic contrast-enhanced magnetic resonance (DCE-MR) perfusion with digital subtraction angiography (DSA) in determining the vascularity of spinal tumors. Objective.: To report on the efficacy of DCE-MR perfusion as a potential noninvasive surrogate for measuring vascularity and thus determine the need for preoperative embolization. Summary of Background Data.: Although primary spinal tumors are rare, spine metastases are relatively common and symptomatic in approximately 14% of patients. Symptomatic patients require palliation with radiotherapy and/or surgery, with possible preoperative endovascular embolization of the tumor. Methods.: A retrospective review revealed 10 patients with 11 diseased vertebral bodies who had received spine DCE-MR perfusion studies and subsequently underwent spinal DSA. Processed MR data were used to calculate a blood flow ratio comparing blood flow with a diseased and an adjacent normal vertebral body. Spinal tumor vascularity was graded on the basis of angiographic tumor blush from 0 (decreased enhancement compared with a normal vertebral body) to 4 (marked tumor blush with early arteriovenous shunting). Results.: Eight vertebral bodies demonstrated increased vascularity on DSA with blood flow ratios of greater than 1.8, 2 vertebral bodies demonstrated normal enhancement on DSA with cerebral blood flow (CBF) ratio of 0.55 to 1.14, and 1 vertebral body level had decreased enhancement on DSA, with a CBF ratio of 0.43. There was a strong correlation between CBF ratio and DSA score, with Spearman ρ = 0.87 (P = 0.00012). Conclusion.: These data show a statistically significant correlation between CBF ratio and DSA and suggest that DCE-MR perfusion can serve as a surrogate to DSA for determining tumor vascularity in patients with extramedullary spinal metastases. © 2014 Lippincott Williams & Wilkins.
Keywords:	spine metastasis; dynamic contrast-enhanced magnetic resonance perfusion (dcemr perfusion); hyper vascular spinal tumors; magnetic resonance perfusion; spine angiography; spine embolization
Journal Title:	Spine
Volume:	39
Issue:	16
ISSN:	0362-2436
Publisher:	Lippincott Williams & Wilkins
Date Published:	2014-07-15
Start Page:	E950
End Page:	E954
Language:	English
DOI:	10.1097/brs.0000000000000409
PROVIDER:	scopus
PUBMED:	24827525
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84904397205&partnerID=40&md5=f206677847e76214f6cdf3db8ba13186
Notes:	Export Date: 1 August 2014 -- CODEN: SPIND -- Source: Scopus

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