Pauliah Mohan, Saxena Vipin, Haris Mohammad, Husain Nuzhat, Rathore Ram Kishore S, Gupta Rakesh K
MR Section, Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Magn Reson Imaging. 2007 Nov;25(9):1292-9. doi: 10.1016/j.mri.2007.03.027. Epub 2007 May 9.
Dynamic contrast-enhanced (DCE) T(1)-weighted magnetic resonance imaging (MRI) is a powerful tool capable of providing quantitative assessment of contrast uptake and characterization of microvascular structure in human gliomas. The kinetics of the bolus injection doped with increasing concentrations of gadopentate dimeglumine (Gd-DTPA) depends on tissue as well as pulse sequence parameters. A simple method is described that overcomes the limitation of relative signal increase measurement and may lead to improved accuracy in quantification of perfusion indices of glioma. Based on an analysis of the contrast behavior of spoiled gradient-recalled echo sequence; a parameter K with arbitrary unit 5.0 is introduced, which provides a better approximation to the differential T(1) relaxation rate. DCE-MRI measurements of relative cerebral blood volume (rCBV) and cerebral blood flow (rCBF) were calculated in 25 patients with brain tumors (15=high-grade glioma, 10=low-grade glioma). The mean rCBV was 6.46 +/- 2.45 in high-grade glioma and 2.89 +/- 1.47 in the low-grade glioma. The rCBF was 3.94 +/- 1.47 in high-grade glioma while 2.25 +/- 0.87 in low-grade glioma. A significant difference in rCBF and rCBV was found between high- and low-grade gliomas. This simple and robust technique reveals the complexity of tumor vasculature and heterogeneity that may aid in therapeutic management especially in nonenhancing high-grade gliomas. We conclude that the precontrast medium steady-state residue parameter K may be useful in improved quantification of perfusion indices in human glioma using T(1)-weighted DCE-MRI.
动态对比增强（DCE）T(1)加权磁共振成像（MRI）是一种强大的工具，能够对人类胶质瘤中的对比剂摄取进行定量评估，并对微血管结构进行表征。注入浓度不断增加的钆喷酸葡胺（Gd-DTPA）的团注动力学取决于组织以及脉冲序列参数。本文描述了一种简单的方法，该方法克服了相对信号增加测量的局限性，可能会提高胶质瘤灌注指数定量的准确性。基于对扰相梯度回波序列对比剂行为的分析，引入了一个单位为5.0的任意参数K，它能更好地近似微分T(1)弛豫率。对25例脑肿瘤患者（15例为高级别胶质瘤，10例为低级别胶质瘤）进行了相对脑血容量（rCBV）和脑血流量（rCBF）的DCE-MRI测量。高级别胶质瘤的平均rCBV为6.46±2.45，低级别胶质瘤为2.89±1.47。高级别胶质瘤的rCBF为3.94±1.47，低级别胶质瘤为2.25±0.87。高级别和低级别胶质瘤之间的rCBF和rCBV存在显著差异。这种简单且可靠的技术揭示了肿瘤血管系统的复杂性和异质性，这可能有助于治疗管理，特别是在无强化的高级别胶质瘤中。我们得出结论，对比剂前稳态残留参数K可能有助于使用T(1)加权DCE-MRI改进人类胶质瘤灌注指数的定量。
