From the Department of Radiology and Research Institute of Radiology (H.S.K., M.J.G., N.K., C.G.C., S.J.K.) and Neurosurgery (J.H.K.), University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul 138-736, Korea.
Radiology. 2014 Dec;273(3):831-43. doi: 10.1148/radiol.14132868. Epub 2014 May 30.
PURPOSE: To compare the added value of dynamic contrast material-enhanced ( CE contrast enhanced ) ( DCE dynamic CE ) magnetic resonance (MR) imaging with that of dynamic susceptibility CE contrast enhanced ( DSC dynamic susceptibility CE ) MR imaging with the combination of CE contrast enhanced T1-weighted imaging and diffusion-weighted ( DW diffusion weighted ) imaging for predicting recurrent glioblastoma. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board, with the requirement for informed patient consent waived. CE contrast enhanced T1-weighted images, DW diffusion weighted images, DSC dynamic susceptibility CE MR images, and DCE dynamic CE MR images in 169 patients with pathologically or clinicoradiologically diagnosed recurrent glioblastoma (n = 87) or radiation necrosis (n = 82) were retrospectively reviewed. Histogram cutoffs of quantitative parametric values were calculated from DW diffusion weighted images, DSC dynamic susceptibility CE MR images, and DCE dynamic CE MR images. Area under the receiver operating characteristic curve ( Az area under the ROC curve ) and interreader agreement were assessed. RESULTS: For predicting recurrent glioblastoma, adding DCE dynamic CE MR imaging to the combination of CE contrast enhanced T1-weighted imaging and DW diffusion weighted imaging significantly improved Az area under the ROC curve from 0.84 to 0.96 for reader 1 and from 0.81 to 0.97 for reader 2, respectively. Adding DSC dynamic susceptibility CE MR imaging also significantly improved Az area under the ROC curve (0.95 for reader 1 and 0.93 for reader 2). However, there was no significant difference in Az between the combination of CE contrast enhanced T1-weighted imaging, DW diffusion weighted imaging, and DSC dynamic susceptibility CE MR imaging and the combination of CE contrast enhanced T1-weighted imaging, DW diffusion weighted imaging, and DCE dynamic CE MR imaging for both readers. The interreader agreement was highest for the combination of CE contrast enhanced T1-weighted imaging, DW diffusion weighted imaging, and DCE dynamic CE MR imaging (κ = 0.78) and lowest for CE contrast enhanced T1-weighted imaging and DW diffusion weighted imaging (κ = 0.65). CONCLUSION: Adding perfusion MR imaging to the combination of CE contrast enhanced T1-weighted imaging and DW diffusion weighted imaging significantly improves the prediction of recurrent glioblastoma; however, selection of perfusion MR method does not affect the diagnostic performance.
目的：比较动态对比增强（CE 对比增强）（DCE 动态 CE）磁共振成像（MR）与动态磁敏感 CE 对比增强（DSC 动态敏感性 CE）MR 成像联合 CE 对比增强 T1 加权成像和扩散加权（DW 扩散加权）成像在预测复发性脑胶质瘤中的附加价值。
材料和方法：这项回顾性研究获得了机构审查委员会的批准，豁免了患者知情同意的要求。回顾性分析了 169 例经病理或临床放射学诊断为复发性脑胶质瘤（n=87）或放射性坏死（n=82）患者的 CE 对比增强 T1 加权图像、DW 扩散加权图像、DSC 动态敏感性 CE MR 图像和 DCE 动态 CE MR 图像。从 DW 扩散加权图像、DSC 动态敏感性 CE MR 图像和 DCE 动态 CE MR 图像中计算定量参数值的直方图截止值。评估受试者工作特征曲线下面积（Az 受试者工作特征曲线下面积）和读者间的一致性。
结果：对于预测复发性脑胶质瘤，在 CE 对比增强 T1 加权成像和 DW 扩散加权成像的基础上增加 DCE 动态 CE MR 成像，可分别使读者 1 的 Az 受试者工作特征曲线下面积从 0.84 提高到 0.96，使读者 2 的 Az 受试者工作特征曲线下面积从 0.81 提高到 0.97。添加 DSC 动态敏感性 CE MR 成像也显著提高了 Az 受试者工作特征曲线下面积（读者 1 为 0.95，读者 2 为 0.93）。然而，对于两位读者，CE 对比增强 T1 加权成像、DW 扩散加权成像和 DSC 动态敏感性 CE MR 成像的组合与 CE 对比增强 T1 加权成像、DW 扩散加权成像和 DCE 动态 CE MR 成像的组合之间的 Az 没有显著差异。CE 对比增强 T1 加权成像、DW 扩散加权成像和 DCE 动态 CE MR 成像的组合的读者间一致性最高（κ=0.78），CE 对比增强 T1 加权成像和 DW 扩散加权成像的一致性最低（κ=0.65）。
结论：在 CE 对比增强 T1 加权成像和 DW 扩散加权成像的基础上增加灌注 MR 成像可显著提高复发性脑胶质瘤的预测效果；然而，灌注 MR 方法的选择并不影响诊断性能。
Acta Neurochir (Wien). 2025-6-21
Cancers (Basel). 2023-8-29
Front Radiol. 2022-6-28
Br J Radiol. 2023-1-1
Cancer Imaging. 2022-6-17
Zotero 插件