Multiparametric analysis using MRI after preoperative embolization in meningioma: a preliminary study.

Abstract

Quantitative evaluation of early perfusion and diffusion changes in meningiomas, including both intratumoral region and peritumoral edema, remains limited within the first 1-2 days postembolization. This study aimed to use multiparametric magnetic resonance imaging (MRI) to investigate early structural and perfusion-related changes in both the intratumoral region and peritumoral edema after preoperative embolization of supratentorial meningiomas. Seven patients with supratentorial meningiomas underwent MRI before and 1-2 days after embolization with Embosphere microspheres (100-300 μm and 300-500 μm), primarily via the middle meningeal artery. Quantitative assessments included intratumoral region and peritumoral edema volumes, quantitative T₂, and intravoxel incoherent motion (IVIM) parameters (D, f, D^*, fD^*, and ΔD). In the intratumoral region, significant reductions in volume (mean change of 28.1%, P = 0.028), quantitative T₂ (mean change of 7.4%, P = 0.028), and all perfusion-related IVIM parameters (f, D^*, fD^*) (P ≤ 0.043) were observed. These findings are consistent with early postembolization ischemia. In contrast, the true diffusion coefficient (D) and the dynamic parameter (ΔD) showed no significant change (P > 0.05). Peritumoral edema showed no significant differences across the measured parameters (P > 0.05). Preoperative embolization is associated with early reductions in viable tumor volume, perfusion-related IVIM parameters, and T₂, reflecting imaging changes consistent with early ischemia primarily within the intratumoral region. The stability of peritumoral edema parameters suggests that early postembolization effects are mainly limited to the intratumoral region.