Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected].
Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected].
复制标题
DOI：
--
复制
发表时间：
2004-02
期刊：
影响因子：
--
通讯作者：
M. Lev;Y. Ozsunar;Y. Ozsunar;J. Henson;Amjad A Rasheed;G. Barest;G. Harsh;M. Fitzek;E. A. Chiocca;James D. Rabinov;Andrew N. Csavoy;B. Rosen;F. Hochberg;P. Schaefer;R. Gonzalez
中科院分区：
文献类型：
--
作者：
M. Lev;Y. Ozsunar;Y. Ozsunar;J. Henson;Amjad A Rasheed;G. Barest;G. Harsh;M. Fitzek;E. A. Chiocca;James D. Rabinov;Andrew N. Csavoy;B. Rosen;F. Hochberg;P. Schaefer;R. Gonzalez
背景与目的：据我们所知，少突胶质细胞瘤和星形细胞瘤在自旋回波（SE）和回波平面相对脑血容量（rCBV）图上的MR成像特征以前未被强调。我们比较了SE rCBV标测与常规对比剂增强MR成像在区分高级别和低级别胶质瘤以及预测这些病变患者生存率方面的特异性。方法对30例拟诊为胶质瘤的成年患者进行常规和rCBV MR成像。从每个病变中选择代表性的最大rCBV感兴趣区域。将所得值标准化为相应的对侧未受累区域的值。这些标准化CBV（nCBV）值与对比增强程度、组织病理学肿瘤分级和生存率相关。结果星形细胞瘤22例，少突胶质细胞瘤8例。nCBV截断比为1.5时，13例高级别星形细胞瘤中有13例被正确分类，其中3例没有增强。9例低级别星形细胞瘤中有7例通过其nCBV值正确分类，包括1例增强病变。在8例少突胶质细胞瘤中，4例高级别肿瘤中的4例和4例低级别肿瘤中的2例nCBV值升高; 2例低级别少突胶质细胞瘤增强，1例nCBV大于1.5，1例nCBV小于1.5。在19例有生存数据的星形细胞瘤患者中，nCBV与生存的相关性（nCBV 1.5的平均生存期为91 +/- 14个月，P <.0001）优于增强（无增强的平均生存期为61 +/- 35个月，增强的平均生存期为22 +/- 29个月，P =.03）。结论：SE rCBV升高是高级别组织病理学的敏感但非特异性标志物：所有高级别肿瘤的nCBV病灶值均大于1.5。nCBV感兴趣区域小于1.5的肿瘤均为高级别（排除高级别的预测值为100%）。与增强程度相比，nCBV升高程度是肿瘤分级和生存率的更强预测因子。低级别胶质细胞肿瘤，最明显的是少突胶质细胞瘤，可能显示高rCBV病灶，而不是高级别组织病理学的反映。
BACKGROUND AND PURPOSE The MR imaging characteristics of oligodendrogliomas and astrocytomas on spin-echo (SE), echo-planar relative cerebral blood volume (rCBV) maps, to our knowledge, have not previously been emphasized. We compared the specificity of SE rCBV mapping with that of conventional, contrast material-enhanced MR imaging in differentiating high- from low-grade glial tumors and in predicting survival of patients with these lesions. METHODS Thirty consecutive adult patients with suspected gliomas underwent conventional and rCBV MR imaging. Representative maximal rCBV regions of interest were chosen from each lesion. Resultant values were normalized to those of corresponding, contralateral, uninvolved regions. These normalized CBV (nCBV) values were correlated with degree of contrast enhancement, histopathologic tumor grade, and survival. RESULTS Twenty-two patients had astroctyomas and eight had oligodendrogliomas. With an nCBV cutoff ratio of 1.5, 13 of 13 high-grade astrocytomas were correctly categorized, three of which did not enhance. Seven of nine low-grade astrocytomas were correctly classified by their nCBV values, including one enhancing lesion. Of eight oligodendrogliomas, four of four high-grade and two of four low-grade tumors had elevated nCBV values; two low-grade oligodendrogliomas enhanced, one with nCBV greater than 1.5 and one with nCBV less than 1.5. In 19 patients with astrocytoma for whom survival data were available, correlation with survival was better for nCBV (mean survival 91 +/- 14 months for nCBV 1.5, P <.0001) than for enhancement (mean survival 61 +/- 35 months without enhancement versus 22 +/- 29 months with enhancement, P =.03). CONCLUSION Elevated SE rCBV was a sensitive, but not specific, marker for high-grade histopathology: all high-grade tumors had nCBV foci values greater than 1.5. No tumor with nCBV region of interest less than 1.5 was high grade (100% predictive value for excluding high grade). Degree of nCBV elevation was a stronger predictor of both tumor grade and survival than was degree of enhancement. A significant proportion of low-grade glial neoplasms, most notably oligodendrogliomas, may display high rCBV foci not reflective of high-grade histopathology.