Evaluation of blood supply using dynamic contrast-enhanced magnetic resonance imaging and its application in spinal tumor surgery.

Objective: This study aimed to assess the utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in evaluating blood supply for spinal tumors and its predictive value for intraoperative blood loss and transfusion requirements during spinal tumor surgery.

Methods: We retrospectively analyzed clinical data from 20 patients with single vertebral tumors who underwent surgery at the Affiliated Hospital of Hebei University of Technology between December 2018 and December 2020. Patients were categorized based on DCE-MRI into two groups: those with tumors indicating rich blood supply (15 patients, with 12 undergoing preoperative embolization) and those with non-rich blood supply tumors (5 patients, without embolization). The primary outcomes measured were blood loss, operation time, and blood transfusion.

Results: The blood flow (BF) ratio from DCE-MRI showed a significant positive correlation with DSA scores (r = 0.569, P < 0.05), indicating the reliability of DCE-MRI in evaluating tumor vascularity. In the group with rich blood supply tumors, the median DSA score was 3.25 (range 3-4), and the BF ratio ranged from 1.84 to 5.14, with a median value greater than 1.8. The BF ratio also correlated significantly with intraoperative bleeding (r = 0.537, P < 0.001) and blood transfusion requirements (r = 0.579, P < 0.001). The correlation with operation time was less pronounced (r = 0.259, P < 0.001).

Conclusion: The DCE-MRI BF ratio is significantly correlated with intraoperative blood loss and transfusion requirements, providing valuable preoperative guidance for spinal tumor surgery. Its non-invasive predictive capabilities offer a clear advantage over traditional angiography, facilitating more informed surgical planning and patient care.