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Perfusion MR imaging: clinical utility for the differential diagnosis of various brain tumors.

Cho SK, Na DG, Ryoo JW, Roh HG, Moon CH, Byun HS, Kim JH - Korean J Radiol (2002 Jul-Sep)

Bottom Line: The highest rCBV ratios were seen in hemangioblastomas, followed by high-grade gliomas, metastases, low-grade gliomas, and lymphomas.At visual assessment, rCBV was high in 17 (81%) of 21 high-grade gliomas and in 4 (50%) of 8 low-grade gliomas.Hemangioblastomas showed the highest rCBV and lymphomas the lowest.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: To determine the utility of perfusion MR imaging in the differential diagnosis of brain tumors.

Materials and methods: Fifty-seven patients with pathologically proven brain tumors (21 high-grade gliomas, 8 low-grade gliomas, 8 lymphomas, 6 hemangioblastomas, 7 metastases, and 7 various other tumors) were included in this study. Relative cerebral blood volume (rCBV) and time-to-peak (TTP) ratios were quantitatively analyzed and the rCBV grade of each tumor was also visually assessed on an rCBV map.

Results: The highest rCBV ratios were seen in hemangioblastomas, followed by high-grade gliomas, metastases, low-grade gliomas, and lymphomas. There was no significant difference in TTP ratios between each tumor group (p<0.05). At visual assessment, rCBV was high in 17 (81%) of 21 high-grade gliomas and in 4 (50%) of 8 low-grade gliomas. Hemangioblastomas showed the highest rCBV and lymphomas the lowest.

Conclusion: Perfusion MR imaging may be helpful in the differentiation of thevarious solid tumors found in the brain, and in assessing the grade of the various glial tumors occurring there.

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Related in: MedlinePlus

Pilocytic astrocytoma in a 13-year-old girl. Enhanced T1-weighted MR image (A) shows that the cerebellum contains a cystic mass with strongly enhancing mural nodules, similar to the hemangioblastoma shown in Fig. 6. rCBV map (B) indicates that the rCBV ratio of these nodules in high (4.65) (arrows), but lower than that of the hemangioblastoma.
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Figure 7: Pilocytic astrocytoma in a 13-year-old girl. Enhanced T1-weighted MR image (A) shows that the cerebellum contains a cystic mass with strongly enhancing mural nodules, similar to the hemangioblastoma shown in Fig. 6. rCBV map (B) indicates that the rCBV ratio of these nodules in high (4.65) (arrows), but lower than that of the hemangioblastoma.

Mentions: Second, an rCBV map is also useful in differentiating cystic astrocytoma from cystic hemangioblastoma. At conventional MR imaging, both cerebellar hemangioblastomas and astrocytomas often appear as small, enhancing nodules within a well circumscribed, thin-walled cyst, as in our cases. Despite some differential features such as an intratumoral signal void, differentiation by conventional MR imaging alone is difficult, especially where tumors are smaller than 1cm (25, 26). Perfusion MR imaging, however, permits differentiation without the need for additional invasive conventional angiography. Quantitative analysis indicated that the rCBV ratio of hemangioblastomas was significantly higher than that of cerebellar astrocytomas, and it was also found that compared with that of gray matter, the signal intensity of hemangioblastomas was higher, while that of cystic astrocytomas was slightly higher (Figs. 6, 7).


Perfusion MR imaging: clinical utility for the differential diagnosis of various brain tumors.

Cho SK, Na DG, Ryoo JW, Roh HG, Moon CH, Byun HS, Kim JH - Korean J Radiol (2002 Jul-Sep)

Pilocytic astrocytoma in a 13-year-old girl. Enhanced T1-weighted MR image (A) shows that the cerebellum contains a cystic mass with strongly enhancing mural nodules, similar to the hemangioblastoma shown in Fig. 6. rCBV map (B) indicates that the rCBV ratio of these nodules in high (4.65) (arrows), but lower than that of the hemangioblastoma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2713881&req=5

Figure 7: Pilocytic astrocytoma in a 13-year-old girl. Enhanced T1-weighted MR image (A) shows that the cerebellum contains a cystic mass with strongly enhancing mural nodules, similar to the hemangioblastoma shown in Fig. 6. rCBV map (B) indicates that the rCBV ratio of these nodules in high (4.65) (arrows), but lower than that of the hemangioblastoma.
Mentions: Second, an rCBV map is also useful in differentiating cystic astrocytoma from cystic hemangioblastoma. At conventional MR imaging, both cerebellar hemangioblastomas and astrocytomas often appear as small, enhancing nodules within a well circumscribed, thin-walled cyst, as in our cases. Despite some differential features such as an intratumoral signal void, differentiation by conventional MR imaging alone is difficult, especially where tumors are smaller than 1cm (25, 26). Perfusion MR imaging, however, permits differentiation without the need for additional invasive conventional angiography. Quantitative analysis indicated that the rCBV ratio of hemangioblastomas was significantly higher than that of cerebellar astrocytomas, and it was also found that compared with that of gray matter, the signal intensity of hemangioblastomas was higher, while that of cystic astrocytomas was slightly higher (Figs. 6, 7).

Bottom Line: The highest rCBV ratios were seen in hemangioblastomas, followed by high-grade gliomas, metastases, low-grade gliomas, and lymphomas.At visual assessment, rCBV was high in 17 (81%) of 21 high-grade gliomas and in 4 (50%) of 8 low-grade gliomas.Hemangioblastomas showed the highest rCBV and lymphomas the lowest.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: To determine the utility of perfusion MR imaging in the differential diagnosis of brain tumors.

Materials and methods: Fifty-seven patients with pathologically proven brain tumors (21 high-grade gliomas, 8 low-grade gliomas, 8 lymphomas, 6 hemangioblastomas, 7 metastases, and 7 various other tumors) were included in this study. Relative cerebral blood volume (rCBV) and time-to-peak (TTP) ratios were quantitatively analyzed and the rCBV grade of each tumor was also visually assessed on an rCBV map.

Results: The highest rCBV ratios were seen in hemangioblastomas, followed by high-grade gliomas, metastases, low-grade gliomas, and lymphomas. There was no significant difference in TTP ratios between each tumor group (p<0.05). At visual assessment, rCBV was high in 17 (81%) of 21 high-grade gliomas and in 4 (50%) of 8 low-grade gliomas. Hemangioblastomas showed the highest rCBV and lymphomas the lowest.

Conclusion: Perfusion MR imaging may be helpful in the differentiation of thevarious solid tumors found in the brain, and in assessing the grade of the various glial tumors occurring there.

Show MeSH
Related in: MedlinePlus