Perfusion and diffusion MR imaging in enhancing malignant cerebral tumors
Perfusion and diffusion MR imaging in enhancing malignant cerebral tumors
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DOI：
10.1016/j.ejrad.2005.12.032
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发表时间：
2006-06-01
影响因子：
3.3
通讯作者：
Akalin, Taner
中科院分区：
文献类型：
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作者：
Calli, Cem;Kitis, Omer;Akalin, Taner
目的：常见的对比度增强的恶性脑肿瘤是多形性胶质母细胞瘤（GBM）、间变性星形细胞瘤（AA）、转移瘤和淋巴瘤，所有这些肿瘤有时都有相似的常规MRI表现。我们的目的是评估的作用，灌注磁共振成像（PWI）和扩散加权成像（DWI）在这些对比增强恶性脑tumors.Materials和方法的分化：48例对比增强和组织学证实的脑肿瘤，14个AA，17 GBM，9个转移瘤，8个淋巴瘤，被列入本研究。所有患者均接受常规MR检查，其中DWI和PWI在同一时间进行。在B值为0、500和1000 mm（2）/s时进行DWI。随后从ADC图图像计算每个肿瘤的最小ADC值（ADC（min））。应用动态磁敏感对比技术进行PWI，计算每个肿瘤的最大相对脑血容量（rCBV（max）），并与对侧正常白色物质的比例。ADC（min）和rCBV（max）值与增强肿瘤的组织学类型进行单因素方差分析和Bonferroni检验。结果：ADC（min）值（平均值+/- S.D.）在GBM、AA、淋巴瘤和转移瘤中分别为0.79 +/- 0.21（X 10（-3）mm（2）/s）、0.75 +/- 0.21（X 10（-3）mm（2）/s）、0.51 +/- 0.09（X 10（-3）mm（2）/s）和0.68 +/- 0.11（X 10（-3）mm（2）/s）。淋巴瘤与GBM的ADC值差异有统计学意义（P < 0.05）。淋巴瘤与再障之间的差异亦有统计学意义（P < 0.03）。然而，在淋巴瘤和转移瘤之间以及GBM、AA和转移瘤之间没有差异。rCBV（max）、比值（平均S.D.）GBM为6.33 ± 2.03，而AA为3.66 ± 1.79，淋巴瘤为2.33 ± 0.68，转移瘤为4.45 ± 1.87。GBM组与AA组、淋巴瘤组比较差异均有统计学意义（P <0.0001）。结论：DWI和PWI结合ADC（min）和rCBV（max）计算，可辅助常规MR成像鉴别脑内增强型恶性肿瘤。(c)2006年由Elsevier爱尔兰有限公司出版。
Objective: Common contrast-enhancing malignant tumors of the brain are glioblastoma multiforme (GBMs), anaplastic astrocytomas (AAs), metastases, and lymphomas, all of which have sometimes similar conventional MRI findings. Our aim was to evaluate the role of perfusion MR imaging (PWI) and diffusion-weighted imaging (DWI) in the differentiation of these contrast-enhancing malignant cerebral tumors.Materials and methods: Forty-eight patients with contrast-enhancing and histologically proven brain tumors, 14 AAs, 17 GBMs, nine metastases, and eight lymphomas, were included in the study. All patients have undergone routine MR examination where DWI and PWI were performed in the same session. DWI was performed with b values of 0, 500, and 1000 mm(2)/s. Minimum ADC values (ADC(min)) of each tumor was later calculated from ADC map images. PWI was applied using dynamic susceptibility contrast technique and maximum relative cerebral blood volume (rCBV(max)) was calculated from each tumor, given in ratio with contralateral normal white matter. Comparisons of ADC(min) and rCBV(max), values with the histological types of the enhancing tumors were made with a one-way analysis of variance and Bonferroni test. A P value less than 0.05 indicated a statistically significant difference.Results: The ADC(min) values (mean +/- S.D.) in GBMs, AAs, lymphomas, and metastases were 0.79 +/- 0.21 (X 10(-3) mm(2)/s), 0.75 +/- 0.21 (X 10(-3) mm(2)/s), 0.51 +/- 0.09 (X 10(-3) mm(2)/s), and 0.68 +/- 0.11 (X 10(-3) mm(2)/s),respectively. The difference in ADC(min) values were statistically significant between lymphomas and GBMs (P < 0.05). It was also statistically significant between lymphomas and AAs (P < 0.03). However, there were no differences between lymphomas and metastasis, and between GBMs, AAs, and metastasis. The rCBV(max), ratio (mean S.D.) in GBMs were 6.33 +/- 2.03, whereas it was 3.66 +/- 1.79 in AAs, 2.33 +/- 0.68 in lymphomas, and 4.45 +/- 1.87 in metastases. These values were statistically different between GBMs and AAs (P < 0.001), GBMs and lymphoma (P < 0.0001). Although there seemed to be difference between GBMs and metastases, it was not statistically significant (P < 0.083).Conclusion: Combination of DWI and PWI, with ADC(min) and rCBV(max) calculations, may aid routine MR imaging in the differentiation of common cerebral contrast-enhancing malignant tumors. (c) 2006 Published by Elsevier Ireland Ltd.