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3Tesla MRI在区分脑胶质瘤复发和治疗后变化(包括放射性坏死)方面是否有用。MRI序列包括对比增强灌注加权成像(PWI)、表观弥散系数(ADC)、磁化率加权成像(SWI)和磁共振波谱(MRS)。双倍剂量对比剂PWI是评价脑血流量的可靠序列，有助于区分脑胶质瘤复发和治疗后的变化。然而，贝伐单抗，一种新推出的减少肿瘤新生血管生成的药物，可能会低估CBV，导致误诊为与治疗相关的变化而存活的肿瘤。在贝伐单抗治疗下，需要对PWI进行进一步评估。对于希望序列之一的ADC值，脑胶质瘤复发的ADC值往往低于治疗相关的改变。SWI和MRS显示两个实体之间存在相当大的重叠。未来的定量分析可能会很有前景。

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.