Usefulness of the 3 tesla MRI in the differential diagnosis between recurrence of glioma and non-tumoral treatment related changes including radiation necrosis.

我们确定了3特斯拉MRI是否有助于区分胶质瘤复发和治疗后变化，包括放射性坏死。本研究中的MRI序列包括对比增强灌注加权成像（PWI）、表观扩散系数（ADC）、磁敏感加权成像（SWI）和MR波谱（MRS）。双剂量对比剂PWI是评价CBV的可靠序列，可用于区分胶质瘤复发和治疗后变化。然而，贝伐单抗，一种新推出的药物，减少肿瘤新生血管生成，可能会低估CBV，导致误诊为治疗相关的变化，活肿瘤。需要进一步评估贝伐珠单抗给药下的PWI。至于ADC，一个有希望的序列，胶质瘤复发的ADC值倾向于显示低于治疗相关变化。社会工作局和货币局发现，这两个实体之间有相当多的重叠。未来的定量分析可能是有希望的。

We determined whether 3 tesla MRI is useful in distinguishing recurrence of glioma from post-treatment changes including radiation necrosis. MRI sequences in this study included contrast-enhanced perfusion weighted imaging (PWI), apparent diffusion coefficient (ADC), susceptibility weighted images (SWI) and MR spectroscopy (MRS). PWI with double-dosed contrast agent was robust sequence for evaluation of CBV and is useful for discrimination between recurrence of gliomas and post-treatment changes. However, bevacizumab, a newly introduced drug which reduces tumor neoangiogenesis, may underestimate CBV, leading to misdiagnose viable tumor as treatment related change. Further evaluation is needed for PWI under administration of bevacizumab. As for ADC, one of the hopeful sequences, recurrence of gliomas had a propensity to show lower ADC value than treatment related changes. SWI and MRS revealed considerable overlaps between two entities. Future quantitative analysis may be promising.