Diffusion tensor analysis of peritumoral edema using lambda chart analysis indicative of the heterogeneity of the microstructure within edema
Diffusion tensor analysis of peritumoral edema using lambda chart analysis indicative of the heterogeneity of the microstructure within edema
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DOI：
10.3171/jns.2005.102.2.0336
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发表时间：
2005-02-01
影响因子：
4.1
通讯作者：
Nakada, T
中科院分区：
文献类型：
--
作者：
Morita, KI;Matsuzawa, H;Nakada, T
Object.组织学研究表明，与肿瘤相关的脑水肿（瘤周水肿）并不代表单一的病理生理学或临床实体。在这项研究中，作者研究了瘤周水肿进行λ图分析（LCA），一种非侵入性的技术，可用于使可见的和分析表观水扩散率在体内组织，并评估的效用LCA区分高级别胶质瘤从nonglial tumors.Methods。通过使用3特斯拉磁共振成像系统对43例患者进行磁共振成像，评估了与4个肿瘤组（12个高级别胶质瘤，5个低级别胶质瘤，11个转移瘤和15个脑膜瘤）相关的瘤周水肿的水扩散率特征。在所有肿瘤组中，与正常白色物质相比，瘤周水肿表现出更大的迹线值和降低的各向异性。高级别胶质瘤相关水肿的迹线值显著高于其他三个肿瘤组相关水肿的迹线值，尽管这些组的各向异性角相当。Lambda图分析确定了两种不同类型的瘤周水肿：与高级别胶质瘤相关的水肿和与低级别胶质瘤或非胶质瘤相关的水肿。高级别胶质瘤的表观水扩散率明显更高，而这些病变的各向异性与其他肿瘤的水肿相当。这些结果表明，水肿区域的水运动，主要是在细胞外空间，在高级别胶质瘤中限制较少，这种现象可能反映了恶性细胞浸润导致细胞外基质超微结构破坏，从而导致更大的水扩散。虽然是初步的，这项研究表明，LCA可以作为一种临床工具，用于区分高级别胶质瘤和评估细胞浸润的程度。
Object. Histopathological studies indicate that cerebral edema associated with tumors (peritumoral edema) does not represent a single pathophysiological or clinical entity. In this study the authors investigated peritumoral edema by performing lambda chart analysis (LCA), a noninvasive technique that can be used to make visible and analyze apparent water diffusivity in tissues in vivo, and assessed the utility of LCA in differentiating high-grade gliomas from nonglial tumors.Methods. The water diffusivity characteristics of peritumoral edema associated with four tumor groups-12 high-grade gliomas, five low-grade gliomas, 11 metastatic tumors, and 15 meningiomas-were assessed in 43 patients by performing magnetic resonance imaging with the aid of a 3-tesla magnetic resonance imaging system. In all tumor groups, peritumoral edema exhibited greater trace values and reduced anisotropy compared with normal white matter. Edema associated with high-grade gliomas had significantly higher trace values than edema associated with the other three tumor groups, although the anisotropic angles of those groups were comparable.Conclusions. Lambda chart analysis identified two distinct types of peritumoral edema: edema associated with high-grade gliomas and edema associated with low-grade gliomas or nonglial tumors. The apparent water diffusivity was significantly greater in high-grade gliomas, whereas the anisotropy in these lesions was comparable to that of edema in other tumors. These findings indicated that water movement in areas of edema, predominantly in the extracellular spaces, was less restricted in high-grade gliomas, a phenomenon that likely reflected the destruction of the extracellular matrix ultrastructure by malignant cell infiltration and consequently greater water diffusion. Although preliminary, this study indicates that LCA could be used as a clinical tool for differentiating high-grade gliomas and for evaluating the extent of cellular infiltration.