Magnetic Resonance Perfusion and Permeability Imaging in Brain Tumors
Magnetic Resonance Perfusion and Permeability Imaging in Brain Tumors
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DOI：
10.1016/j.nic.2009.08.007
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发表时间：
2009-11-01
影响因子：
2.3
通讯作者：
Law, Meng
中科院分区：
文献类型：
--
作者：
Lacerda, Saulo;Law, Meng
最近的证据表明，除了血管生成外，血管通透性和血管内皮生长因子/血管通透性因子（VEGFNPF）的存在也是脑肿瘤生长的重要介质。灌注和通透性磁共振（MR）成像现在可以测量脑血容量和血管通透性等参数，这些参数可以直接与这些组织病理变化以及VEGF等分子标志物相关。目前在临床和研究中使用的主要技术是t1加权稳态动态对比增强MR成像（DOE MR成像）和T2*加权首次通过动态敏感性对比MR成像（DSC MR成像）。本文讨论了每种技术在表征肿瘤生物学方面的优点和缺点。目前，大多数临床医生和研究人员正在使用DSC磁共振成像T2*加权技术进行脑肿瘤灌注磁共振成像。人类神经胶质瘤病理分类的多种方法的存在意味着专家之间缺乏共识，即哪一种是最好的方法。然而，这些多重分级系统在确定胶质瘤生物学的重要组织学参数上是一致的，即高细胞性、多形性、血管内皮增殖、有丝分裂活性和坏死。
Recent evidence suggests that vascular permeability and the presence of vascular endothelial growth factor/vascular permeability factor (VEGFNPF) are important mediators of brain tumor growth in addition to angiogenesis. Perfusion and permeability magnetic resonance (MR) imaging can now measure parameters such as cerebral blood volume and vascular permeability, which can be directly correlated with these histopathologic changes as well as molecular markers such as VEGF. The major techniques currently used in both the clinical and research settings are T1-weighted steady-state dynamic contrast-enhanced MR imaging (DOE MR imaging) and T2*-weighted first-pass, dynamic susceptibility contrast MR imaging (DSC MR imaging). The advantages and disadvantages of each technique with regard to characterizing tumor biology are discussed in this article. Most clinicians and investigators are currently using the DSC MR imaging T2*-weighted technique for brain tumor perfusion MR imaging. The existence of multiple approaches to pathologic classification of human glioma implies that there is a lack of consensus among experts as to which is the single best approach. These multiple grading systems do, however, agree on the histologic parameters that are important in the determination of glioma biology, namely hypercellularity, pleomorphism, vascular endothelial proliferation, mitotic activity, and necrosis.