Institute of Neuroradiology, Goethe University, Frankfurt, Germany.
Clin Neuroradiol. 2011 Sep;21(3):123-39. doi: 10.1007/s00062-011-0073-6. Epub 2011 May 3.
Conventional magnetic resonance (MR) imaging of space-occupying lesions may answer most of the questions concerning the diagnosis and subsequent treatment strategies if patient age, clinical and paraclinical findings are considered as well. However, crucial and relevant differential diagnoses require additional MR methods, such as diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI) and magnetic resonance spectroscopy (MRS). In necrotic ring-enhancing lesions DWI may detect inflammatory processes, whereas characteristics of the peritumoral area may help to distinguish between metastases and glioblastomas. In solid tumors DWI, PWI and MRS may also aid the differentiation between low-grade gliomas and malignant tumors, such as gliomas WHO (World Health Organization) grade III and IV and lymphomas. This review briefly explains special MR methods with respect to brain tumors and illustrates the diagnostic pathways necessary for supplying a reliable diagnosis as well as optimal pre-operative imaging of space-occupying brain lesions.
对于占位性病变的常规磁共振（MR）成像，如果结合患者年龄、临床和辅助检查结果进行综合考虑，通常可以回答大多数与诊断和后续治疗策略相关的问题。然而，对于一些关键且重要的鉴别诊断，则需要额外的磁共振方法，如弥散加权成像（DWI）、灌注加权成像（PWI）和磁共振波谱（MRS）。在坏死性环形增强病变中，DWI 可检测到炎症过程，而肿瘤周围区域的特征有助于区分转移瘤和胶质母细胞瘤。在实体瘤中，DWI、PWI 和 MRS 也有助于区分低级别胶质瘤和恶性肿瘤，如 WHO 分级 III 级和 IV 级胶质瘤和淋巴瘤。本文简要介绍了脑肿瘤的特殊磁共振方法，并说明了提供可靠诊断和最佳术前占位性脑病变成像所需的诊断路径。
