Altered intraoperative cerebrovascular reactivity in brain areas of high-grade glioma recurrence
Altered intraoperative cerebrovascular reactivity in brain areas of high-grade glioma recurrence
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DOI：
10.1016/j.mri.2016.02.003
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发表时间：
2016-07-01
影响因子：
2.5
通讯作者：
Bozinov, Oliver
中科院分区：
文献类型：
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作者：
Fierstra, Jorn;van Niftrik, Bas;Bozinov, Oliver
引言：目前的MRI序列在识别高级别胶质瘤复发风险的脑区方面有限。我们采用术中3特斯拉功能性MRI评估脑血管反应性（CVR）后，高级别胶质瘤切除术和分析区域CVR反应在肿瘤复发的地区，临床随访imaging.Methods：5例高级别胶质瘤，进行了术中血氧水平依赖（BOLD）MRI CVR检查，并有至少18个月的临床随访，从前瞻性数据库中选择。对于本研究，肿瘤复发的位置与术中成像在空间上匹配，以评估该特定区域的CVR反应。CVR被定义为百分比BOLD信号的变化在重复的周期的apnea.Results：的5名受试者（平均年龄44岁，2名女性），4名被诊断为WHO级HI和1名受试者与WHO IV级胶质瘤。3例受试者在临床随访MRI中显示肿瘤复发（平均：15个月）。在肿瘤复发的空间匹配区域测量的BOLD CVR平均增加94（范围-32%至183%）与对侧半球CVR反应相比，分别为1.50 +/- 0.81与1.03 +/- 0.46（p = 031）。对于在一个小队列中的第一次分析，我们发现在临床随访成像中显示高级别胶质瘤复发的脑区域中的术中CVR改变。(C)2016 Elsevier Inc. All rights reserved.
Introduction: Current MRI sequences are limited in identifying brain areas at risk for high grade glioma recurrence. We employed intraoperative 3-Tesla functional MRI to assess cerebrovascular reactivity (CVR) after high-grade glioma resection and analyzed regional CVR responses in areas of tumor recurrence on clinical follow-up imaging.Methods: Five subjects with high-grade glioma that underwent an intraoperative Blood Oxygen-Level Dependent (BOLD) MRI CVR examination and had a clinical follow-up of at least 18 months were selected from a prospective database. For this study, location of tumor recurrence was spatially matched to the intraoperative imaging to assess CVR response in that particular area. CVR is defined as the percent BOLD signal change during repeated cycles of apnea.Results: Of the 5 subjects (mean age 44, 2 females), 4 were diagnosed with a WHO grade HI and 1 subject with a WHO grade IV glioma. Three subjects exhibited a tumor recurrence on clinical follow-up MRI (mean: 15 months). BOLD CVR measured in the spatially matched area of tumor recurrence was on average 94% increased (range - 32% to 183%) as compared to contralateral hemisphere CVR response, 1.50 +/- 0.81 versus 1.03 +/- 0.46 respectively (p = 031).Conclusion: For this first analysis in a small cohort, we found altered intraoperative CVR in brain areas exhibiting high grade glioma recurrence on clinical follow-up imaging. (C) 2016 Elsevier Inc. All rights reserved.