Goebell Einar, Paustenbach Susanne, Vaeterlein Ole, Ding Xiao-Qi, Heese Oliver, Fiehler Jens, Kucinski Thomas, Hagel Christian, Westphal Manfred, Zeumer Hermann
Department of Neuroradiology, University of Hamburg, Martinistrasse 52, 20251 Hamburg, Germany.
Radiology. 2006 Apr;239(1):217-22. doi: 10.1148/radiol.2383050059. Epub 2006 Feb 16.
To prospectively evaluate whether diffusion-tensor magnetic resonance (MR) imaging depicts differences in World Health Organization (WHO) grade II and III glial brain tumors on the basis of tumor architecture and peritumoral tract invasion.
The study protocol was approved by the local ethics committee, and written informed consent was obtained. Diffusion-tensor MR imaging was performed in 23 patients (15 men, eight women; mean age, 47 years) with histologically confirmed brain gliomas. Eleven of the 23 tumors were low-grade gliomas (WHO grade II) and 12 were anaplastic gliomas (WHO grade III). Regions of interest were placed in the tumor center, tumor border, normal-appearing white matter (NAWM) adjacent to the tumor, and NAWM of the contralateral hemisphere. fractional anisotropy (FA) ratios were calculated for regions of interest in relation to the NAWM of the contralateral hemisphere. Pairwise comparisons were performed by using the Mann-Whitney U test.
Median FA ratios for grade II versus grade III gliomas were 0.406 versus 0.405, respectively, for tumor center, 0.733 versus 0.449, respectively, for tumor border, and 0.962 versus 0.943, respectively, for NAWM adjacent to the tumor. Differences in FA ratio between low-grade and high-grade tumors were significant in the tumor border only (P = .01). Differences in FA ratio were not significant between low-grade and high-grade gliomas in the tumor center or in the NAWM adjacent to the tumor.
The periphery of low-grade gliomas contains a considerable amount of preserved fiber tracts. In high-grade gliomas, however, most of these tracts are disarranged. Low FA ratios in the tumor center are consistent with a high degree of disorganization of myelinated fiber tracts in the center of both low-grade and high-grade gliomas.
前瞻性评估扩散张量磁共振成像（MR）是否能基于肿瘤结构和瘤周纤维束侵犯情况显示世界卫生组织（WHO）二级和三级脑胶质瘤之间的差异。
本研究方案经当地伦理委员会批准，并获得了书面知情同意书。对23例经组织学证实为脑胶质瘤的患者（15例男性，8例女性；平均年龄47岁）进行了扩散张量MR成像检查。23例肿瘤中，11例为低级别胶质瘤（WHO二级），12例为间变性胶质瘤（WHO三级）。在肿瘤中心、肿瘤边界、肿瘤相邻的外观正常白质（NAWM）以及对侧半球的NAWM区域放置感兴趣区。计算感兴趣区相对于对侧半球NAWM的分数各向异性（FA）比值。采用Mann-Whitney U检验进行两两比较。
二级与三级胶质瘤在肿瘤中心的FA比值中位数分别为0.406和0.405，在肿瘤边界分别为0.733和0.449，在肿瘤相邻的NAWM分别为0.962和0.943。低级别和高级别肿瘤之间FA比值的差异仅在肿瘤边界有统计学意义（P = 0.01）。低级别和高级别胶质瘤在肿瘤中心或肿瘤相邻的NAWM中FA比值的差异无统计学意义。
低级别胶质瘤周边含有大量保存完好的纤维束。然而，在高级别胶质瘤中，这些纤维束大多排列紊乱。肿瘤中心低FA比值与低级别和高级别胶质瘤中心有髓纤维束高度紊乱一致。
