Provenzale James M, York Gerald, Moya Marcelo Galvez, Parks Lauren, Choma Michael, Kealey Susan, Cole Patricia, Serajuddin Humaira
Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710, USA.
AJR Am J Roentgenol. 2006 Oct;187(4):1036-42. doi: 10.2214/AJR.04.0676.
The purpose of this study was to correlate the degree of contrast enhancement on dynamic contrast-enhanced T1-weighted MRI and the relative cerebral blood volume (rCBV) values on T2*-weighted MRI in patients with high-grade brain neoplasms.
Ten patients with biopsy-proven high-grade gliomas underwent dynamic contrast-enhanced MRI using T1-weighted fast spoiled gradient-echo technique (TR/TE, 8.3/1.5) during i.v. infusion of 0.1 mmol/kg of MR contrast medium. This sequence was followed within 5 minutes by dynamic susceptibility contrast (DSC) imaging (1,500/80) during i.v. infusion of 0.2 mmol/kg of MR contrast medium. Dynamic contrast-enhanced analysis was performed using the maximum-signal-intensity algorithm, and DSC analysis was performed using the negative enhancement integral program. For each tumor, we performed two comparisons: first, the average dynamic contrast-enhanced and rCBV values within a region of interest drawn around the entire contrast-enhancing tumor on a single image through the center of the lesion and, second, the highest dynamic contrast-enhanced and highest rCBV values within each tumor. Statistical analyses of the first comparison were performed using Pearson's correlation coefficient, R2 correlation coefficient, and Spearman's rank correlation and for the second comparison using Kendall's tau correlation.
The mean signal intensity values ranged between 3.48 and 7.16 SDs above baseline values (mean, 4.89 SDs). The mean rCBV values ranged between 57.9% and 122.7% of the normal lentiform nucleus (mean, 76.6%). The Pearson's correlation coefficient was 0.867, the R2 correlation coefficient was 0.752, and the Spearman's rank correlation was 0.794 (p = 0.001). Dynamic contrast-enhanced values from the region of highest signal intensity ranged between 7.7 and 48.6 SDs above baseline values (mean, 17.3 SDs). The highest rCBV values ranged between 105% and 400% of the normal lentiform nucleus (mean, 292%). The correlation was estimated to be 0.7778 and was statistically significant at the 0.01 level of statistical significance (p = 0.0035).
We found a high correlation between degree of contrast enhancement on dynamic contrast-enhanced images and rCBV values in whole tumors and in regions having the highest degree of contrast enhancement in this small study. Our findings, which suggest that relative permeability and rCBV values may be correlated in high-grade glial neoplasms, deserve further study in a larger patient population.
本研究旨在探讨高级别脑肿瘤患者动态对比增强T1加权磁共振成像（MRI）的对比增强程度与T2*加权MRI上的相对脑血容量（rCBV）值之间的相关性。
10例经活检证实为高级别胶质瘤的患者，静脉注射0.1 mmol/kg的磁共振造影剂时，采用T1加权快速扰相梯度回波技术（TR/TE，8.3/1.5）进行动态对比增强MRI检查。在5分钟内，静脉注射0.2 mmol/kg的磁共振造影剂时，采用动态磁敏感对比（DSC）成像（1500/80）。使用最大信号强度算法进行动态对比增强分析，使用负增强积分程序进行DSC分析。对于每个肿瘤，我们进行了两项比较：第一，在通过病变中心的单幅图像上围绕整个对比增强肿瘤绘制的感兴趣区域内的平均动态对比增强值和rCBV值；第二，每个肿瘤内的最高动态对比增强值和最高rCBV值。第一项比较的统计分析采用Pearson相关系数、R2相关系数和Spearman秩相关，第二项比较采用Kendall tau相关。
平均信号强度值在高于基线值3.48至7.16个标准差之间（平均，4.89个标准差）。平均rCBV值在正常豆状核的57.9%至122.7%之间（平均，76.6%）。Pearson相关系数为0.867，R2相关系数为0.752，Spearman秩相关为0.794（p = 0.001）。最高信号强度区域的动态对比增强值在高于基线值7.7至48.6个标准差之间（平均，17.3个标准差）。最高rCBV值在正常豆状核的105%至400%之间（平均，292%）。相关性估计为0.7778，在0.01的统计学显著性水平上具有统计学意义（p = 0.0035）。
在这项小型研究中，我们发现动态对比增强图像上的对比增强程度与整个肿瘤以及对比增强程度最高区域的rCBV值之间存在高度相关性。我们的研究结果表明，相对通透性和rCBV值在高级别胶质肿瘤中可能相关，值得在更大的患者群体中进一步研究。
