Wetzel Stephan G, Cha Soonmee, Law Meng, Johnson Glyn, Golfinos John, Lee Peter, Nelson Peter Kim
Department of Radiology, New York University Medical Center, New York, NY 10016, USA.
AJNR Am J Neuroradiol. 2002 Nov-Dec;23(10):1767-74.
In evaluating intracranial tumors, a safe low-cost alternative that provides information similar to that of digital subtraction angiography (DSA) may be of interest. Our purpose was to determine the utility and limitations of a combined MR protocol in assessing (neo-) vascularity in intracranial tumors and their relation to adjacent vessels and to compare the results with those of DSA.
Twenty-two consecutive patients with an intracranial tumor who underwent preoperative stereoscopic DSA were examined with contrast-enhanced dynamic T2*-weighted perfusion MR imaging followed by a T1-weighted three-dimensional (3D) MR study (volumetric interpolated brain examination [VIBE]). The maximum relative cerebral blood volume (rCBV) of the tumor was compared with tumor vascularity at DSA. Critical vessel structures were defined in each patient, and VIBE images of these structures were compared with DSA findings. For full exploitation of the 3D data sets, maximum-intensity projection algorithms reconstructed in real time with any desired volume and orientation were used.
Tumor blush scores at DSA were significantly correlated with the rCBV measurements (r = 0.75; P <.01, Spearman rank correlation coefficient). In 17 (77%) patients, VIBE provided all relevant information about the venous system, whereas information about critical arteries were partial in 50% of the cases and not relevant in the other 50%.
A fast imaging protocol consisting of perfusion MR imaging and a volumetric MR acquisition provides some of the information about tumor (neo-) vascularity and adjacent vascular anatomy that can be obtained with conventional angiography. However, the MR protocol provides insufficient visualization of distal cerebral arteries.
在评估颅内肿瘤时，一种能提供与数字减影血管造影（DSA）类似信息的安全、低成本替代方法可能会受到关注。我们的目的是确定一种联合磁共振成像（MR）方案在评估颅内肿瘤（新）血管形成及其与相邻血管关系方面的实用性和局限性，并将结果与DSA进行比较。
对22例连续接受术前立体定向DSA检查的颅内肿瘤患者进行了对比增强动态T2*加权灌注磁共振成像检查，随后进行T1加权三维（3D）MR研究（容积内插脑检查[VIBE]）。将肿瘤的最大相对脑血容量（rCBV）与DSA检查时的肿瘤血管形成情况进行比较。确定每位患者的关键血管结构，并将这些结构的VIBE图像与DSA结果进行比较。为了充分利用3D数据集，使用了可根据需要的任何体积和方向实时重建的最大强度投影算法。
DSA检查时的肿瘤染色评分与rCBV测量值显著相关（r = 0.75；P <.01，Spearman等级相关系数）。在17例（77%）患者中，VIBE提供了有关静脉系统的所有相关信息，而在50%的病例中，有关关键动脉的信息不完整，在另外50%的病例中则不相关。
由灌注磁共振成像和容积MR采集组成的快速成像方案可提供一些通过传统血管造影可获得的有关肿瘤（新）血管形成和相邻血管解剖结构的信息。然而，MR方案对大脑远端动脉的可视化不足。
