Singh Jeannine Brunner, Oevermann Anna, Lang Johann, Vandevelde Marc, Doherr Marcus, Henke Diana, Gorgas Daniela
Department of Clinical Veterinary Medicine Vetsuisse Faculty Bern, Bern, Switzerland.
Vet Radiol Ultrasound. 2011 Nov-Dec;52(6):619-26. doi: 10.1111/j.1740-8261.2011.01848.x.
Certain magnetic resonance (MR) enhancement patterns are often considered to be associated with a specific diagnosis but experience shows that this association is not always consistent. Therefore, it is not clear how reliably contrast enhancement patterns correlate with specific tissue changes. We investigated the detailed histomorphologic findings of intracranial lesions in relation to Gadodiamide contrast enhancement in 55 lesions from 55 patients, nine cats, and 46 dogs. Lesions were divided into areas according to their contrast enhancement; therefore 81 areas resulted from the 55 lesions which were directly compared with histopathology. In 40 of 55 lesions (73%), the histomorphologic features explained the contrast enhancement pattern. In particular, vascular proliferation and dilated vessels occurred significantly more often in areas with enhancement than in areas without enhancement (P = 0.044). In 15 lesions, there was no association between MR images and histologic findings. In particular, contrast enhancement was found within necrotic areas (10 areas) and ring enhancement was seen in lesions without central necrosis (five lesions). These findings imply that necrosis cannot be differentiated reliably from viable tissue based on postcontrast images. Diffusion of contrast medium within lesions and time delays after contrast medium administration probably play important roles in the presence and patterns of contrast enhancement. Thus, histologic features of lesions cannot be predicted solely by contrast enhancement patterns.
某些磁共振（MR）增强模式常被认为与特定诊断相关，但经验表明这种关联并不总是一致的。因此，尚不清楚对比增强模式与特定组织变化的关联有多可靠。我们研究了55例患者、9只猫和46只狗的55个颅内病变与钆双胺对比增强相关的详细组织形态学发现。根据病变的对比增强情况将其分为不同区域；因此，55个病变共产生81个区域，并将这些区域直接与组织病理学进行比较。在55个病变中的40个（73%）中，组织形态学特征解释了对比增强模式。特别是，增强区域中血管增生和血管扩张的发生率明显高于无增强区域（P = 0.044）。在15个病变中，MR图像与组织学发现之间无关联。特别是，在坏死区域内发现了对比增强（10个区域），在无中央坏死的病变中出现了环形增强（5个病变）。这些发现表明，基于对比剂注射后的图像无法可靠地区分坏死组织与存活组织。对比剂在病变内的扩散以及注射对比剂后的时间延迟可能在对比增强的出现和模式中起重要作用。因此，不能仅通过对比增强模式来预测病变的组织学特征。
