Evaluation of different cerebral mass lesions by perfusion‐weighted MR imaging

Abstract

Purpose:To investigate the contribution of perfusionweighted MR imaging (PWI) by using the relative cerebral blood volume (rCBV) ratio in the differential diagnosis of various intracranial space-occupying lesions. Materials and Methods:This study involved 105 patients with lesions (high-grade glioma (N ϭ 26), low-grade glioma (Nϭ 11), meningioma (N ϭ 23), metastasis (N ϭ 25), hemangioblastoma (N ϭ 6), pyogenic abscess (N ϭ 4), schwannoma (N ϭ 5), and lymphoma (N ϭ 5)). The patients were examined with a T2*-weighted (T2*W) gradient-echo singleshot EPI sequence. The rCBV ratios of the lesions were obtained by dividing the values obtained from the normal white matter. Statistical analysis was performed with the Mann-Whitney U-test. A P-value less than 0.05 was considered statistically significant. Results:The rCBV ratio was 5.76 Ϯ 3.35 in high-grade gliomas, 1.69 Ϯ 0.51 in low-grade gliomas, 8.02 Ϯ 3.89 in meningiomas, 5.27 Ϯ 3.22 in metastases, 11.36 Ϯ 4.41 in hemangioblastomas, 0.76 Ϯ 0.12 in abscesses, 1.10 Ϯ 0.32 in lymphomas, and 3.23 Ϯ 0.81 in schwannomas. The rCBV ratios were used to discriminate between 1) high-and low-grade gliomas (P Ͻ 0.001), 2) hemangioblastomas and metastases (PϽ 0.05), 3) abscesses from high-grade gliomas and metastases (P Ͻ 0.001), 4) schwannomas and meningiomas (P Ͻ 0.001), 5) lymphomas from high-grade gliomas and metastases (P Ͻ 0.001), and 6) typical meningiomas and atypical meningiomas (P Ͻ 0.01).Conclusion: rCBV ratios can help discriminate intracranial space-occupying lesions by demonstrating lesion vascularity. It is possible to discriminate between 1) high-and low-grade gliomas, 2) hemangioblastomas and other intracranial posterior fossa masses, 3) abscesses from highgrade gliomas and metastases, 4) schwannomas and meningiomas, 5) lymphomas and high-grade gliomas and metastases, and 6) typical and atypical meningiomas.

Optimal Location for Arterial Input Function Measurements near the Middle Cerebral Artery in First-Pass Perfusion MRI

“…These parameters enable the identification and characterization of pathologic areas in brain tissue. Perfusion-weighted imaging can identify tissue at risk of infarction in stroke patients, facilitate grading and delineation of brain tumors, and can provide important hemodynamic information in, for example, Alzheimer's disease, obstructive cerebrovascular disease and migraine (Hakyemez et al, 2006;Harris et al, 1998;Kluytmans et al, 1998;Sorensen et al, 1999).…”

Central Nervous System Lymphoma: Characteristic Findings on Traditional and Advanced Imaging

“…This characteristic finding can help to differentiate glioblastomas and metastases from lymphomas. 40,52 Both perfusion MR imaging and perfusion CT may demonstrate increased microvascular permeability in tumor tissue based on quantification of the permeability surface area product and the contrast transfer coefficient. 50,53 Several studies have reported that these parameters measured on MR imaging correlate with the mitotic index, histologic grading, and biologic aggressiveness of gliomas, but this correlation has not yet been investigated with regard to CNS lymphomas.…”

MR Imaging–Based Analysis of Glioblastoma Multiforme: Estimation ofIDH1Mutation Status

“…In addition, correlations were recently identified between the prognosis of patients with GBM and several functional imaging parameters, including ADC derived from DWI, tumor blood volume calculated from DSC, and tumor blood flow (TBF) calculated from arterial spin-labeling (ASL) perfusion MR imaging. [2][3][4][5][6][7] ASL is a recently developed MR perfusion imaging technique that has advantages of being noninvasive, not requiring an extrinsic tracer, and allowing reliable absolute quantification, which is not affected by a disrupted blood-brain barrier. 8 ASL is increasingly recognized as a noninvasive method for quantitative CBF measurement for assessing stroke, neurodegenerative diseases, and brain tumors.…”