Abnormal Enhancements After Contrast Injection

Caillé, J. M.; Guibert-Tranier, F; Calabet, A.; Billerey, J.; Piton, J

doi:10.1007/978-3-642-67513-3_25

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…Moreover, electron microscopic studies of gliomas have revealed a direct relationship between the degree of abnormality in capillary endothelial cells and their tight junctions and the degree of anaplasia [27,28]. In low-grade gliomas, new capillary formations resemble normal cerebral capillaries with maintenance of the BBB, and, therefore, no enhancement is seen [29]. On the other hand, angiogenesis in more malignant tumors leads to the formation of abnormal blood vessels, with absent or incomplete BBB, which allows enhancement by the contrast agent [28][29][30].…”

Section: Enhancementmentioning

confidence: 99%

“…In low-grade gliomas, new capillary formations resemble normal cerebral capillaries with maintenance of the BBB, and, therefore, no enhancement is seen [29]. On the other hand, angiogenesis in more malignant tumors leads to the formation of abnormal blood vessels, with absent or incomplete BBB, which allows enhancement by the contrast agent [28][29][30]. Although GBM belongs to the latter group of tumors, some glioblastomas may exhibit minimal or no gadolinium enhancement whatsoever [23].…”

Section: Enhancementmentioning

confidence: 99%

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Prognostic significance of preoperative MRI scans in glioblastoma multiforme

et al. 1996

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Tumor necrosis, enhancement, and associated edema in patients with glioblastoma multiforme (GBM) represent biological variables that can be quantitated on preoperative MRI scans. We reviewed 48 highly selected patients, all of whom had supratentorial lesions, had undergone gross total tumor resection, and had received adjuvant treatments (radio- and chemotherapies). None of these patients had had surgery for recurrent tumor resection and none had harbored multifocal tumors. The median age was 50 years. The median Karnofsky performance score was 80. Multivariate analysis using the Cox regression model revealed that the strongest prognostic variable was the amount of tumor necrosis on preoperative scan (P < 0.001), with median survivals of 42, 24, 15, and 12 months for tumor necrosis grades of 0 (7 'pts'), I (11 'pts'), II (9 'pts'), and III (21 'pts'), respectively. The intensity of enhancement of the tumor nodule was another prognostic factor (P = 0.003), with median survivals of 35, 18, and 13.5 months for enhancement grades of 0 (2 'pts'), I (22 'pts'), and II (24 'pts'), respectively. The extent of peritumoral edema had a quadratic effect (P = 0.001), with grades I (19 'pts'), II (22 'pts'), and III (7 'pts') surviving for 24, 12, and 20 months respectively. Location and volume of tumors were not statistically significant predictors of survival (P < 0.05). In conclusion, in this highly selected group, GBM patients with little or no necrosis and with less tumor nodule enhancement on preoperative MRI survive longer than patients with greater amounts of necrosis and greater degrees of tumor enhancement. In addition, a moderate degree of peritumoral edema is associated with worse prognosis.

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Section: Enhancementmentioning

confidence: 99%

Section: Enhancementmentioning

confidence: 99%

Prognostic significance of preoperative MRI scans in glioblastoma multiforme

et al. 1996

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CNS Imaging and the Brain Barriers

Sage¹,

Turski²,

Levin³

1989

Implications of the Blood-Brain Barrier and Its Manipulation

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Prognostic significance of proteolytic enzymes in human brain tumors

et al. 1994

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Proteases and their inhibitors have been shown to play roles in tumor invasion and metastasis in a number of experimental models. Recently, relative increases in the amounts of urokinase type plasminogen activator (uPA) and plasminogen activator inhibitor-1 (PAI-1) in tumor samples have been correlated with poorer, pathological grade, shorter disease-free interval, and shorter survival. To date, all studies investigating the prognostic significance of proteases and their inhibitors have been limited to extracranial cancer. In this article, we review the literature and present our data on the prognostic significance of proteases in human brain tumors. High levels of uPA were seen in malignant glioma and metastatic tumors (n = 82), whereas normal levels of uPA were found in low-grade gliomas. Analysis with magnetic resonance imaging (MRI) demonstrated a significant correlation between high levels of uPA and necrosis and edema (n = 50; P < 0.05). Similarly, patients with high levels of uPA had shorter survival than did patients with low levels of uPA. Tissue-type plasminogen activator (tPA), which was virtually absent in glioblastoma multiforme (GBM), colon lung, and breast metastasis, was found in normal quantities in anaplastic astrocytoma (AA), low-grade glioma (LGG), and meningioma. Melanoma had significantly more tPA activity than normal brain did. A reverse correlation was found between tPA and MRI findings of necrosis, enhancement, and edema. Similarly, patients with no detectable tPA activity had shorter survival than did patients with detectable tPA activity. We conclude that high levels of uPA and absent tPA activity correlate with histologically malignant brain tumors, aggressive characteristics, and shorter survival.

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Abnormal Enhancements After Contrast Injection

Cited by 6 publications

References 11 publications

Prognostic significance of preoperative MRI scans in glioblastoma multiforme

Prognostic significance of preoperative MRI scans in glioblastoma multiforme

CNS Imaging and the Brain Barriers

Prognostic significance of proteolytic enzymes in human brain tumors

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