Sahin Neslin, Melhem Elias R, Wang Sumei, Krejza Jaroslaw, Poptani Harish, Chawla Sanjeev, Verma Gaurav
Department of Radiology, Sifa University School of Medicine; İzmir, Turkey -
Neuroradiol J. 2013 Oct;26(5):531-41. doi: 10.1177/197140091302600506. Epub 2013 Nov 7.
A significant number of nonenhancing (NE) gliomas are reported to be malignant. The purpose of this study was to compare the value of advanced MR imaging techniques, including T2*-dynamic susceptibility contrast PWI (DSC-PWI) and proton magnetic resonance spectroscopy ((1)HMRS) in the evaluation of NE gliomas. Twenty patients with NE gliomas underwent MRI including DSC-PWI and (1)HMRS. The relative CBV (rCBV) measurements were obtained from regions of maximum perfusion. The peak ratios of choline/creatine (Cho/Cr) and myo-inositol/creatine (mIns/Cr) were measured at a TE of 30 ms. Demographic features, tumor volumes, and PWI- and (1)HMRS-derived measures were compared between low-grade gliomas (LGGs) and high-grade gliomas (HGGs). In addition, the association of initial rCBV ratio with tumor progression was evaluated in LGGs. No significant difference was noted in age, sex or tumor size between LGGs and HGGs. Cho/Cr ratios were significantly higher in HGGs (1.7±0.63) than in LGGs (1.2±0.38). The receiver operating characteristic analysis demonstrated that a Cho/Cr ratio with a cutoff value of 1.3 could differentiate between LGG and HGG with a specificity of 100% and a sensitivity of 71.4%. There was no significant difference in the rCBV ratio and the mIns/Cr ratio between LGG and HGG. However, higher rCBV ratios were observed with more rapid progressions in LGGs. The results imply that Cho/Cr ratios are useful in distinguishing NE LGG from HGG and can be helpful in preoperative grading and biopsy guidance. On the other hand, rCBV ratios do not help in the distinction.
据报道，相当数量的无强化（NE）胶质瘤是恶性的。本研究的目的是比较包括T2 * -动态磁敏感对比增强灌注加权成像（DSC-PWI）和质子磁共振波谱（（1）HMRS）在内的先进磁共振成像技术在评估NE胶质瘤中的价值。20例NE胶质瘤患者接受了包括DSC-PWI和（1）HMRS的MRI检查。从最大灌注区域获得相对脑血容量（rCBV）测量值。在30 ms的回波时间测量胆碱/肌酸（Cho/Cr）和肌醇/肌酸（mIns/Cr）的峰值比。比较了低级别胶质瘤（LGG）和高级别胶质瘤（HGG）之间的人口统计学特征、肿瘤体积以及PWI和（1）HMRS衍生指标。此外，在LGG中评估了初始rCBV比值与肿瘤进展的相关性。LGG和HGG在年龄、性别或肿瘤大小方面未观察到显著差异。HGG的Cho/Cr比值（1.7±0.63）显著高于LGG（1.2±0.38）。受试者工作特征分析表明，Cho/Cr比值截断值为1.3时可区分LGG和HGG，特异性为100%，敏感性为71.4%。LGG和HGG之间的rCBV比值和mIns/Cr比值无显著差异。然而，在LGG中观察到rCBV比值越高，进展越快。结果表明，Cho/Cr比值有助于区分NE LGG和HGG，可有助于术前分级和活检指导。另一方面，rCBV比值无助于区分。
