Essig Marco, Weber Marc-André, von Tengg-Kobligk Hendrik, Knopp Michael V, Yuh William T C, Giesel Frederik L
Department of Radiology, German Cancer Research Center, Heidelberg, Germany.
Top Magn Reson Imaging. 2006 Apr;17(2):89-106. doi: 10.1097/01.rmr.0000245464.36148.dc.
Brain tumors are one of the most common neoplasms in young adults and are associated with a high mortality and disability rate. Magnetic resonance imaging (MRI) is widely accepted to be the most sensitive imaging modality in the assessment of cerebral neoplasms. Because the detection, characterization, and exact delineation of brain tumors require a high lesion contrast that depends on the signal of the lesion in relation to the surrounding tissue, contrast media is given routinely. Anatomical and functional, contrast agent-based MRI techniques allow for a better differential diagnosis, grading, and especially therapy decision, planing, and follow-up. In this article, the basics of contrast enhancement of brain tumors will be reviewed. The underlying pathology of a disrupted blood-brain barrier and drug influences will be discussed. An overview of the currently available contrast media and the influences of dosage, field strength, and application on the tumor tissue contrast will be given. Challenging, contrast-enhanced, functional imaging techniques, such as perfusion MRI and dynamic contrast-enhanced MRI, are presented both from the technical side and the clinical experience in the assessment of brain tumors. The advantages over conventional, anatomical MRI techniques will be discussed as well as possible pitfalls and drawbacks.
脑肿瘤是年轻成年人中最常见的肿瘤之一，且与高死亡率和致残率相关。磁共振成像（MRI）被广泛认为是评估脑肿瘤最敏感的成像方式。由于脑肿瘤的检测、特征描述及精确勾勒需要高病变对比度，而这取决于病变相对于周围组织的信号，因此通常会使用造影剂。基于造影剂的解剖学和功能MRI技术有助于更好地进行鉴别诊断、分级，尤其是治疗决策、规划及随访。本文将回顾脑肿瘤对比增强的基础知识。还将讨论血脑屏障破坏的潜在病理学及药物影响。将概述当前可用的造影剂以及剂量、场强和应用对肿瘤组织对比度的影响。从技术层面和评估脑肿瘤的临床经验方面介绍具有挑战性的对比增强功能成像技术，如灌注MRI和动态对比增强MRI。将讨论其相对于传统解剖学MRI技术的优势以及可能存在的陷阱和缺点。
