Contrast enhancement of malignant gliomas and the development of peritumoral edema are thought to be due to a breakdown of the blood-brain barrier (BBB). The degree to which these two factors are related to each other or to the degree of damage to the BBB is unknown. Our purpose was to quantitatively correlate the degree of enhancement with Gd-DTPA of anaplastic gliomas and glioblastoma multiforme with the volume of surrounding edema. In 14 patients, quantitative measurements of the volume of peritumoral edema and the degree of contrast enhancement were made. A high degree of correlation was found (r = 0.86, P < 0.01). These results can be viewed as indirect, radiological evidence that edema production is quantitatively related to the degree of breakdown of the BBB as determined by gadolinium enhancement. These results imply that the origin of the edema is in the area of breakdown of the BBB.
During the pandemic of novel coronavirus infection (COVID-19), computed tomography (CT) showed its effectiveness in diagnosis of coronavirus infection. However, ionizing radiation during CT studies causes concern for patients who require dynamic observation, as well as for examination of children and young people. For this retrospective study, we included 15 suspected for COVID-19 patients who were hospitalized in April 2020, Russia. There were 4 adults with positive polymerase chain reaction (PCR) test for COVID-19. All patients underwent magnetic resonance imaging (MRI) examinations using MR-LUND PROTOCOL: Single-shot Fast Spin Echo (SSFSE), LAVA 3D and IDEAL 3D, Echo-planar imaging (EPI) diffusion-weighted imaging (DWI) and Fast Spin Echo (FSE) T2 weighted imaging (T2WI). On T2WI changes were identified in 9 (60,0%) patients, on DWI – in 5 (33,3%) patients. In 5 (33,3%) patients lesions of the parenchyma were visualized on T2WI and DWI simultaneously. At the same time, 4 (26.7%) patients had changes in lung tissue only on T2WI. (P(McNemar) = 0,125; OR = 0,00 (95%); kappa = 0,500). In those patients who had CT scan, the changes were comparable to MRI. The results showed that in case of CT is not available, it is advisable to conduct a chest MRI for patients with suspected or confirmed COVID-19. Considering that T2WI is a fluid-sensitive sequence, if imaging for the lung infiltration is required, we can recommend the abbreviated MRI protocol consisting of T2 and T1 WI. These data may be applicable for interpreting other studies, such as thoracic spine MRI, detecting signs of viral pneumonia of asymptomatic patients. MRI can detect features of viral pneumonia.
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