Differentiation of low-grade oligodendrogliomas from low-grade astrocytomas by using quantitative blood-volume measurements derived from dynamic susceptibility contrast-enhanced MR imaging.
Differentiation of low-grade oligodendrogliomas from low-grade astrocytomas by using quantitative blood-volume measurements derived from dynamic susceptibility contrast-enhanced MR imaging.
复制标题
DOI：
--
复制
发表时间：
2005-02
期刊：
影响因子：
--
通讯作者：
S. Cha;T. Tihan;Forrest W. Crawford;N. Fischbein;Susan M. Chang;A. Bollen;S. Nelson;M. Prados;M. Berger;W. Dillon
中科院分区：
文献类型：
--
作者：
S. Cha;T. Tihan;Forrest W. Crawford;N. Fischbein;Susan M. Chang;A. Bollen;S. Nelson;M. Prados;M. Berger;W. Dillon
背景与目的组织病理学评估仍然是胶质瘤诊断和组织学亚型分类的参考标准，但受到主观标准、组织采样误差和缺乏特异性肿瘤标志物的挑战。解剖成像对于神经胶质瘤的手术计划至关重要，但由于其非特异性和无法描述形态畸变而受到限制。我们研究的目的是探讨两种最常见的低级别浸润性胶质瘤亚型：星形细胞瘤和少突胶质细胞瘤的动态敏感性对比增强（DSC） MR成像特征。我们假设，从DSC MR成像中获得的肿瘤血容量测量将有助于根据肿瘤血管的差异区分两者。方法：我们连续研究了25例未经治疗、经组织病理学证实的世界卫生组织II级星形细胞瘤（n = 11）或少突胶质细胞瘤（n = 14）患者。所有患者在手术切除前立即进行解剖和DSC磁共振成像。所有患者均获得组织学证实。分析解剖MR图像的形态学特征，并对DSC MR数据进行处理以产生定量脑血容量（CBV）测量。结果星形细胞瘤的最大相对CBV（rCBV(max)）范围为0.48 ~ 1.34(0.92 +/- 0.27，中位+/- SD)，少突胶质细胞瘤的rCBV（max）范围为1.29 ~ 9.24（3.68 +/- 2.39）。两种肿瘤类型的中位rCBV（max）差异有统计学意义（P < 0.0001）。结论低级别少突胶质细胞瘤的rCBV（max）值明显高于星形细胞瘤。我们的研究结果表明，DSC MR成像得出的肿瘤rCBV（max）可用于区分两种低级别胶质瘤。
BACKGROUND AND PURPOSE Histopathologic evaluation remains the reference standard for diagnosis of glioma and classification of histologic subtypes, but is challenged by subjective criteria, tissue sampling error, and lack of specific tumor markers. Anatomic imaging is essential for surgical planning of gliomas but is limited by its nonspecificity and its inability to depict beyond morphologic aberrations. The purpose of our study was to investigate dynamic susceptibility contrast-enhanced (DSC) MR imaging characteristics of the two most common subtypes of low-grade infiltrating glioma: astrocytoma and oligodendroglioma. We hypothesized that tumor blood-volume measurements, derived from DSC MR imaging, would help differentiate the two on the basis of differences in tumor vascularity. METHODS We studied 25 consecutive patients with treatment-naive, histopathologically confirmed World Health Organization grade II astrocytoma (n = 11) or oligodendroglioma (n = 14). All patients underwent anatomic and DSC MR imaging immediately before surgical resection. Histologic confirmation was obtained in all patients. Anatomic MR images were analyzed for morphologic features, and DSC MR data were processed to yield quantitative cerebral blood volume (CBV) measurements. RESULTS The maximum relative CBV (rCBV(max)) in tumor ranged from 0.48 to 1.34 (0.92 +/- 0.27, median +/- SD) in astrocytomas and from 1.29 to 9.24 (3.68 +/- 2.39) in oligodendrogliomas. The difference in median rCBV(max) between the two tumor types was significant (P < .0001). CONCLUSION The tumor rCBV(max) measurements derived from DSC MR imaging were significantly higher in low-grade oligodendrogliomas than in astrocytomas. Our findings suggest that tumor rCBV(max) derived from DSC MR imaging can be used to distinguish between the two low-grade gliomas.