Cha S, Yang L, Johnson G, Lai A, Chen M-H, Tihan T, Wendland M, Dillon W P
Department of Radiology, University of California at San Francisco, San Francisco, California 94143, USA.
AJNR Am J Neuroradiol. 2006 Feb;27(2):409-17.
The widely accepted MR method for quantitating brain tumor microvascular permeability, K(trans), is the steady-state T1-weighted gradient-echo method (ssT1). Recently the first-pass T2*-weighted (fpT2*) method has been used to derive both relative cerebral blood volume (rCBV) and K(trans). We hypothesized that K(trans) derived from the ssT1 and the fpT2* methods will correlate differently in gliomas and meningiomas because of the unique differences in morphologic and functional status of each tumor vascular network.
Before surgery, 27 patients with newly diagnosed gliomas (WHO grade I-IV; n = 20) or meningiomas (n = 7) underwent conventional anatomic MR imaging and 12 dynamic ssT1 acquisitions followed by 60 dynamic fpT2* images before and after gadopentate dimeglumine administration. The 3 hemodynamic variables-fpT2* rCBV, fpT2* K(trans), and ssT1 K(trans)-were calculated in anatomically identical locations and correlated with glioma grade. The fpT2* K(trans) values were compared with ssT1 K(trans) for gliomas and meningiomas.
All 3 hemodynamic variables displayed distinct distributions among grades 2, 3, and 4 gliomas by using the Kruskal-Wallis test. Only K(trans) values, and not rCBV, could differentiate between grade 4 and lower-grade gliomas by using the Wilcoxon rank sum test. The fpT2* K(trans) was highly predictive of ssT1 K(trans) for gliomas, with an estimated regression coefficient of 0.49 (P < .001). For meningiomas, however, fpT2* K(trans) values correlated poorly with ssT1 K(trans) values (r = 0.26; P = .74).
Compared with rCBV, K(trans) values derived from either ssT1 or fpT2* were more predictive of glioma grade. The fpT2* K(trans) was highly correlated with ssT1 K(trans) in gliomas but not in meningiomas.
广泛认可的用于定量脑肿瘤微血管通透性(Ktrans)的磁共振成像(MR)方法是稳态T1加权梯度回波法(ssT1)。最近,首次通过T2加权(fpT2)方法已被用于推导相对脑血容量(rCBV)和Ktrans。我们推测,由于每种肿瘤血管网络在形态和功能状态上的独特差异,通过ssT1和fpT2*方法得出的Ktrans在胶质瘤和脑膜瘤中的相关性会有所不同。
在手术前,27例新诊断的胶质瘤(世界卫生组织分级I - IV级;n = 20)或脑膜瘤(n = 7)患者接受了传统的解剖学MR成像,并在静脉注射钆喷酸葡胺前后进行了12次动态ssT1采集,随后采集60次动态fpT2图像。在解剖学上相同的位置计算3个血流动力学变量——fpT2 rCBV、fpT2* Ktrans和ssT1 Ktrans,并与胶质瘤分级相关联。比较了胶质瘤和脑膜瘤的fpT2* Ktrans值与ssT1 Ktrans值。
通过Kruskal - Wallis检验,所有3个血流动力学变量在2级、3级和4级胶质瘤之间显示出明显的分布差异。使用Wilcoxon秩和检验时,只有Ktrans值而非rCBV能够区分4级和低级别的胶质瘤。对于胶质瘤,fpT2* Ktrans对ssT1 Ktrans具有高度预测性,估计回归系数为0.49(P <.001)。然而,对于脑膜瘤,fpT2* Ktrans值与ssT1 Ktrans值的相关性较差(r = 0.26;P =.74)。
与rCBV相比,通过ssT1或fpT2得出的Ktrans值对胶质瘤分级更具预测性。fpT2 Ktrans在胶质瘤中与ssT1 Ktrans高度相关,但在脑膜瘤中并非如此。