High-grade gliomas and solitary metastases: Differentiation by using perfusion and proton spectroscopic MR Imaging
High-grade gliomas and solitary metastases: Differentiation by using perfusion and proton spectroscopic MR Imaging
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DOI：
10.1148/radiol.2223010558
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发表时间：
2002-03-01
期刊：
影响因子：
19.7
通讯作者：
Litt, AW
中科院分区：
文献类型：
--
作者：
Law, M;Cha, S;Litt, AW
目的：根据肿瘤周围血管和代谢物水平的差异，确定MR灌注加权和质子光谱成像是否可以用于区分高级别原发性胶质瘤和孤立性转移瘤。材料和方法：51例孤立性脑肿瘤患者（33例胶质瘤，18例转移瘤）在手术切除或立体定向活检前接受了常规、造影剂增强灌注加权和质子光谱磁共振成像。在33例胶质瘤患者中，22例接受灌注加权MR成像；九、磁共振光谱成像；还有两个人两者都做了。在18例转移患者中，12例接受灌注加权磁共振成像，6例接受磁共振光谱成像。肿瘤周围区域被定义为紧邻肿瘤增强区（t2加权图像显示为高信号，但对比后t1加权图像显示为不增强）的白质区域。根据灌注加权MR数据计算这些区域的相对脑血容量。二维磁共振成像获得增强肿瘤、瘤周区域和正常脑的光谱。使用学生t检验来确定高级别胶质瘤和转移瘤之间的相对脑血容量和代谢比率是否有统计学上的显著差异。结果：高级别胶质瘤和转移瘤的瘤周相对脑血容量分别为1.31 +/- 0.97（平均+/- SD）和0.39 +/- 0.19。差异有统计学意义（P < 0.001）。光谱成像显示在胶质瘤瘤周胆碱水平升高（胆碱与肌酸比值为2.28±1.24），但在转移瘤中没有升高（胆碱与肌酸比值为0.76±0.23）。差异有统计学意义（P = .001）。结论：虽然孤立性转移瘤和原发性高级别胶质瘤的常规磁共振成像特征有时可能相似，但灌注加权和光谱磁共振成像可以区分两者。(c) rsna， 2002年。
PURPOSE: To determine whether perfusion-weighted and proton spectroscopic MR imaging can be used to differentiate high-grade primary gliomas and solitary metastases on the basis of differences in vascularity and metabolite levels in the peritumoral region.MATERIALS AND METHODS: Fifty-one patients with a solitary brain tumor (33 gliomas, 18 metastases) underwent conventional, contrast material-enhanced perfusion-weighted, and proton spectroscopic MR imaging before surgical resection or stereotactic biopsy. Of the 33 patients with gliomas, 22 underwent perfusion-weighted MR imaging; nine, spectroscopic MR imaging; and two underwent both. Of the 18 patients with metastases, 12 underwent perfusion-weighted MR imaging, and six, spectroscopic MR imaging. The peritumoral region was defined as the area in the white matter immediately adjacent to the enhancing (hyperintense on T2-weighted images, but not enhancing on postcontrast T1-weighted images) portion of the tumor. Relative cerebral blood volumes in these regions were calculated from perfusion-weighted MR data. Spectra from the enhancing tumor, the peritumoral region, and normal brain were obtained from the two-dimensional spectroscopic MR acquisition. The Student t test was used to determine if there was a statistically significant difference in relative cerebral blood volume and metabolic ratios between high-grade gliomas and metastases.RESULTS: The measured relative cerebral blood volumes in the peritumoral region in high-grade gliomas and metastases were 1.31 +/- 0.97 (mean +/- SD) and 0.39 +/- 0.19, respectively. The difference was statistically significant (P < .001). Spectroscopic imaging demonstrated elevated choline levels (choline-to-creatine ratio was 2.28 ± 1.24) in the peritumoral region of gliomas but not in metastases (choline-to-creatine ratio was 0.76 ± 0.23). The difference was statistically significant (P = .001).CONCLUSION: Although conventional MR imaging characteristics of solitary metastases and primary high-grade gliomas may sometimes be similar, perfusion-weighted and spectroscopic MR imaging enable distinction between the two. (C) RSNA, 2002.