Parikh Anup H, Smith J Keith, Ewend Matthew G, Bullitt Elizabeth
School of Medicine, University of North Carolina, School of Medicine, 3327 Old Infirmary CB 7510, Chapel Hill, NC 27599-7510, USA.
Technol Cancer Res Treat. 2004 Dec;3(6):585-90. doi: 10.1177/153303460400300608.
Advances in noninvasive imaging techniques such as magnetic resonance perfusion imaging have been found useful in grading cerebral neoplasms and have potential for significant clinical benefit. The purpose of this study was to determine the correlation between tumor vessel tortuosity as measured from vessels extracted from magnetic resonance angiograms (MRA) and perfusion parameters of cerebral blood flow (CBF) and cerebral blood volume (CBV) in intracranial neoplasms. We hypothesized that tumor blood vessel tortuosity measures and perfusion measures would be correlated, since both are increased by tumor angiogenesis. 18 patients with 19 cerebral neoplasms were evaluated with conventional MR imaging and dynamic contrast-enhanced T2-weighted perfusion MR imaging (PWI). Both benign and malignant lesions were included, as were hyper- and hypovascular tumors. Regions of interest were plotted within the tumor area to locate foci of maximum CBV and CBF. CBV and CBF measurements were also recorded in contralateral normal appearing white matter to calculate relative CBV (rCBV) and relative CBF (rCBF). Vessel tortuosity analyses were conducted upon vessels segmented from MRA images of the same patients using two tortuosity descriptors (SOAM and ICM), which have previously been demonstrated to have efficacy in separating benign from malignant disease. Linear regression analyses were conducted to determine if correlations exist between CBV or CBF and the two tortuosity measurements. For the overall set of tumors, no significant correlations were found between flow or volume measures and the tortuosity measures. However, when the 7 glioblastoma multiforme tumors were examined as a subgroup, the following significant correlations were found: rCBV and SOAM (R2=0.799), rCBV and ICM (R2=0.214). Our results demonstrate that MR perfusion imaging data do not correlate significantly with vessel tortuosity parameters as determined from the larger vessels seen by MRA. However, for subgroups of a particular tumor type such as GBM, there may be significant correlations. It appears that perfusion and tortuosity data may provide independently useful data in the assessment of cerebral neoplasms.
诸如磁共振灌注成像等非侵入性成像技术的进展已被证明在脑肿瘤分级中有用，并且具有显著临床益处的潜力。本研究的目的是确定从磁共振血管造影（MRA）提取的血管测量的肿瘤血管迂曲度与颅内肿瘤中脑血流量（CBF）和脑血容量（CBV）的灌注参数之间的相关性。我们假设肿瘤血管迂曲度测量和灌注测量将相关，因为两者都因肿瘤血管生成而增加。对18例患有19个脑肿瘤的患者进行了常规磁共振成像和动态对比增强T2加权灌注磁共振成像（PWI）评估。纳入了良性和恶性病变，以及高血管和低血管肿瘤。在肿瘤区域内绘制感兴趣区域，以定位最大CBV和CBF的病灶。还记录了对侧正常外观白质中的CBV和CBF测量值，以计算相对CBV（rCBV）和相对CBF（rCBF）。使用两种迂曲度描述符（SOAM和ICM）对同一患者的MRA图像分割出的血管进行血管迂曲度分析，这两种描述符先前已被证明在区分良性和恶性疾病方面有效。进行线性回归分析以确定CBV或CBF与两种迂曲度测量之间是否存在相关性。对于整个肿瘤组，未发现血流或容积测量与迂曲度测量之间存在显著相关性。然而，当将7例多形性胶质母细胞瘤肿瘤作为一个亚组进行检查时，发现了以下显著相关性：rCBV与SOAM（R2 = 0.799），rCBV与ICM（R2 = 0.214）。我们的结果表明，磁共振灌注成像数据与MRA所见较大血管确定的血管迂曲度参数无显著相关性。然而，对于特定肿瘤类型的亚组，如胶质母细胞瘤，可能存在显著相关性。看来灌注和迂曲度数据在脑肿瘤评估中可能提供独立有用的数据。
