3T高分辨率对比增强磁共振成像及磁敏感加权成像在脑肿瘤患者中的应用：与正电子发射断层扫描及组织病理学结果的相关性
High-resolution contrast-enhanced, susceptibility-weighted MR imaging at 3T in patients with brain tumors: correlation with positron-emission tomography and histopathologic findings.
作者信息
Pinker K, Noebauer-Huhmann I M, Stavrou I, Hoeftberger R, Szomolanyi P, Karanikas G, Weber M, Stadlbauer A, Knosp E, Friedrich K, Trattnig S
机构信息
MR Centre of Excellence, Department of Radiology, Medical University Vienna, Vienna, Austria.
出版信息
AJNR Am J Neuroradiol. 2007 Aug;28(7):1280-6. doi: 10.3174/ajnr.A0540.
BACKGROUND AND PURPOSE
The purpose of this work was to demonstrate susceptibility effects (SusE) in various types of brain tumors with 3T high-resolution (HR)-contrast-enhanced (CE)-susceptibility-weighted (SW)-MR imaging and to correlate SusE with positron-emission tomography (PET) and histopathology.
MATERIALS AND METHODS
Eighteen patients with brain tumors, scheduled for biopsy or tumor extirpation, underwent high-field (3T) MR imaging. In all of the patients, an axial T1-spin-echo (SE) sequence and an HR-SW imaging sequence before and after IV application of a standard dose of contrast agent (MultiHance) was obtained. Seven patients preoperatively underwent PET. The frequency and formation of intralesional SusE in all of the images were evaluated and correlated with tumor grade as determined by PET and histopathology. Direct correlation of SusE and histopathologic specimens was performed in 6 patients. Contrast enhancement of the lesions was assessed in both sequences.
RESULTS
High-grade lesions demonstrated either high or medium frequency of SusE in 90% of the patients. Low-grade lesions demonstrated low frequency of SusE or no SusE. Correlation between intralesional frequency of SusE and histopathologic, as well as PET, tumor grading was statistically significant. Contrast enhancement was equally visible in both SW and SE sequences. Side-to-side comparison of tumor areas with high frequency of SusE and histopathology revealed that intralesional SusE reflected conglomerates of increased tumor microvascularity.
CONCLUSIONS
3T HR-CE-SW-MR imaging shows both intratumoral SusE not visible with standard MR imaging and contrast enhancement visible with standard MR imaging. Because frequency of intratumoral SusE correlates with tumor grade as determined by PET and histopathology, this novel technique is a promising tool for noninvasive differentiation of low-grade from high-grade brain tumors and for determination of an optimal area of biopsy for accurate tumor grading.
背景与目的
本研究旨在通过3T高分辨率（HR）对比增强（CE）磁共振成像（MRI）显示不同类型脑肿瘤的磁敏感效应（SusE），并将SusE与正电子发射断层扫描（PET）及组织病理学结果进行相关性分析。
材料与方法
18例计划行活检或肿瘤切除的脑肿瘤患者接受了高场强（3T）MRI检查。所有患者均在静脉注射标准剂量造影剂（MultiHance）前后分别进行了轴位T1加权自旋回波（SE）序列及HR-SW成像序列扫描。7例患者术前接受了PET检查。评估所有图像中瘤内SusE的频率及形成情况，并与PET及组织病理学确定的肿瘤分级进行相关性分析。对6例患者的SusE与组织病理学标本进行了直接相关性分析。在两个序列中均评估了病变的对比增强情况。
结果
90%的高级别病变显示SusE频率高或中等。低级别病变显示SusE频率低或无SusE。瘤内SusE频率与组织病理学及PET肿瘤分级之间的相关性具有统计学意义。SW序列和SE序列中对比增强均清晰可见。对SusE频率高的肿瘤区域与组织病理学进行的双侧比较显示，瘤内SusE反映了肿瘤微血管增多的团块。
结论
3T HR-CE-SW-MRI既能显示标准MRI无法显示的瘤内SusE，又能显示标准MRI可见的对比增强。由于瘤内SusE频率与PET及组织病理学确定的肿瘤分级相关，因此这项新技术是一种有前景的工具，可用于低级别与高级别脑肿瘤的无创鉴别诊断，以及确定最佳活检区域以进行准确的肿瘤分级。
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