Aprile Italo, Giovannelli Giorgia, Fiaschini Paola, Muti Marco, Kouleridou Anna, Caputo Nevia
Neuroradiology Unit, S. Maria Hospital, Terni, Italy.
Radiotherapy Unit, S. Maria Hospital, Terni, Italy.
Radiol Med. 2015 Oct;120(10):967-74. doi: 10.1007/s11547-015-0511-7. Epub 2015 Mar 12.
Evaluation of cerebral blood volume (CBV) with magnetic resonance (MR) imaging can differentiate low-grade from high-grade gliomas. The percentage of signal recovery (PSR) in the venous phase of perfusion curves is inversely proportional to blood-brain barrier (BBB) permeability. Since even BBB permeability relates to glioma malignancy grade, we carried out a comparative evaluation between CBV and PSR to characterise cerebral gliomas.
Forty-nine patients with cerebral gliomas were studied with MR perfusion imaging. In all tumours, both maximum CBV and minimum PSR were calculated. The difference between the CBV and PSR mean values among the low-grade and high-grade gliomas was assessed using statistical methods. We also examined whether there was an additional difference between low-grade and grade III gliomas. Finally, CBV and PSR diagnostic sensitivity and specificity in identifying low-grade gliomas compared to all gliomas and low-grade gliomas compared to all gliomas excluding glioblastomas was assessed.
A significant difference between low-grade and high-grade gliomas with both CBV and PSR was demonstrated. Conversely, there was a significant difference between low-grade and grade III gliomas only with PSR, while CBV did not show significant difference. Finally, superior sensitivity and specificity of PSR compared to CBV in identifying low-grade gliomas was demonstrated both compared to all gliomas and all gliomas excluding glioblastomas.
The PSR evaluation proved better than CBV for determining the grade of brain and is therefore a useful tool to be considered in the MR evaluation of gliomas.
利用磁共振成像评估脑血容量（CBV）可区分低级别与高级别胶质瘤。灌注曲线静脉期的信号恢复百分比（PSR）与血脑屏障（BBB）通透性成反比。由于BBB通透性甚至与胶质瘤恶性程度相关，我们对CBV和PSR进行了比较评估以对脑胶质瘤进行特征描述。
对49例脑胶质瘤患者进行了磁共振灌注成像研究。在所有肿瘤中，均计算了最大CBV和最小PSR。采用统计学方法评估低级别和高级别胶质瘤之间CBV和PSR平均值的差异。我们还检查了低级别和III级胶质瘤之间是否存在额外差异。最后，评估了CBV和PSR在鉴别低级别胶质瘤与所有胶质瘤以及低级别胶质瘤与除胶质母细胞瘤外的所有胶质瘤方面的诊断敏感性和特异性。
低级别和高级别胶质瘤在CBV和PSR方面均显示出显著差异。相反，仅PSR在低级别和III级胶质瘤之间存在显著差异，而CBV未显示出显著差异。最后，与所有胶质瘤以及除胶质母细胞瘤外的所有胶质瘤相比，PSR在鉴别低级别胶质瘤方面显示出比CBV更高的敏感性和特异性。
PSR评估在确定脑胶质瘤级别方面被证明优于CBV，因此是胶质瘤磁共振评估中一个值得考虑的有用工具。
