Primary and metastatic intraaxial brain tumors: prospective comparison of multivoxel 2D chemical-shift imaging (CSI) proton MR spectroscopy, perfusion MRI, and histopathological findings in a group of 159 patients
Primary and metastatic intraaxial brain tumors: prospective comparison of multivoxel 2D chemical-shift imaging (CSI) proton MR spectroscopy, perfusion MRI, and histopathological findings in a group of 159 patients
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DOI：
10.1007/s00701-010-0833-0
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发表时间：
2011-02-01
影响因子：
2.4
通讯作者：
Di Paola, Francesco
中科院分区：
文献类型：
--
作者：
Bendini, Matteo;Marton, Elisabetta;Di Paola, Francesco
本研究旨在通过比较神经影像学数据与切除或活检后的组织病理学结果，评估多体素二维化学位移成像（CSI）质子磁共振（MR）波谱联合灌注磁共振成像（MRI）在脑肿瘤鉴别诊断和分级中的诊断价值。共有159例既往诊断为脑肿瘤的患者接受了多体素二维CSI质子磁共振波谱和灌注MRI。磁共振光谱多体素二维CSI，回波时间30，TR 1500，视场160 mm，采集时间7 min 34 s， rCBV图在后处理时进行评估。对分布正态性检验进行统计分析，采用对数变换、Fisher检验和Bonferroni检验。我们用皮尔逊检验来比较百分比。MR光谱多体素2D CSI联合动态对比增强MRI （DCE-MRI）灌注对GBM与转移的鉴别诊断具有较高的敏感性和特异性（p < 0.000001）。在脑肿瘤分级中，同样的方法在区分III-IV级胶质瘤时达到了很高的敏感性和特异性（p < 0.000001），但在两组主要的原发性脑肿瘤中，特别是在涉及混合胶质瘤时，很难确定级别。系统地使用CSI光谱和灌注成像在脑肿瘤的鉴别诊断和分级中显示出很高的潜力。需要进一步探索能够明显区分III-IV级和II级肿瘤的诊断方法。
This study aims to assess the diagnostic value of multivoxel 2D chemical-shift imaging (CSI) proton magnetic resonance (MR) spectroscopy combined with perfusion magnetic resonance imaging (MRI) in the differential diagnosis and grading of brain tumors by comparing neuroimaging data with histopathological findings obtained after resection or biopsy.A total of 159 patients with a previous brain tumor diagnosis underwent multivoxel 2D CSI proton MR spectroscopy and perfusion MRI. MR spectroscopy multivoxel 2D CSI was performed with an echo time of 30, TR 1,500, FOV 160 mm, acquisition time 7 min 34 s. rCBV maps were evaluated during postprocessing. Statistical analysis was performed on the examination of distributive normality, with logarithmic transformations, Fisher's test, and Bonferroni's test. We used the Pearson's test to compare percentages.In the differential diagnosis between GBM and metastases, MR spectroscopy multivoxel 2D CSI, combined with dynamic contrast enhanced MRI (DCE-MRI) perfusion, reached high sensibility and specificity (p < 0.000001). In brain tumor grading, the same method reached high sensibility and specificity (p < 0.000001) in distinguishing grade III-IV gliomas but encountered difficulty in determining grades within the two main groups of primary brain tumors, especially where mixed gliomas were involved.The systematic use of CSI spectroscopy and perfusion imaging has shown a high potential in the differential diagnosis and grading of brain tumors. Further exploration into diagnostic procedures that can significantly distinguish between grade III-IV and grade II tumors is needed.