Perfusion MR imaging of a patient after resection of a left parieto-occipital glioma. (a, c, d) Dynamic contrast-enhanced SW GRE echo-planar perfusion images (GRE-EPI; Siemens) (1490/40; flip angle, 90°; bandwidth, 1502 Hz/pixel; voxel size, 1.8 × 1.8 × 5.0 mm; FOV, 230 × 230 mm; echo-planar imaging factor, 128; 60 measurements) were obtained during rapid intravenous injection of gadopentetate dimeglumine. (a) Axial source image shows that all of the areas having high concentrations of gadolinium, such as arteries, are dark. (b) Graph of signal intensity versus time represents changes in signal intensity during injection of gadolinium-based contrast agent. Decrease in signal intensity between BLe and FPe lines represents first pass of contrast agent through the circulation. BLe = baseline ends, BLs = baseline starts, FPe = end of first pass. (c, d) Tracer kinetics software is applied to the curve of signal intensity versus time to obtain various color maps, where red and yellow represent high value and blue represents low value of the particular parameter. (c) Color maps show cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), time to peak (TTP), corrected cerebral blood volume (CCBV), and permeability map (K2). (d) Separate map shows CCBV. In this case, blue (representing low flow) is seen in and around the resection cavity (arrow in c and d), which suggests that there is no viable tumor in this region. (Case courtesy of Meher Ursekar, MD, Jankharia-Piramal Imaging, Mumbai, India.)