Kamble Ravindra B, Jayakumar Peruvumba N, Shivashankar Ravishankar
Department of Radiology, Vikram Hospital, Bangalore, Karnataka, India.
Department of Radiology, Khoula Hospital, Muscat, Oman.
Indian J Radiol Imaging. 2015 Apr-Jun;25(2):162-6. doi: 10.4103/0971-3026.155866.
Differentiating intracranial mass lesions on CT scan is challenging. The purpose of our study was to determine the perfusion parameters in various intracranial space-occupying lesions (ICSOL), differentiate benign and malignant lesions, and differentiate between grades of gliomas.
We performed CT perfusion (CTP) in 64 patients, with age ranging from 17 to 68 years, having space-occupying lesions in brain and calculated relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCBV).
We found significantly lower perfusion in low-grade gliomas as compared to high-grade tumors, lymphoma, and metastases. Similarly in infective lesions, TWT and abscesses showed significantly lower perfusion compared to TOT. In ring enhancing lesions, capsule of TWT showed significantly lower perfusion as compared to abscesses, TOT, and metastases.
Thus, in conclusion, infective lesions can be differentiated from tumors like lymphomas, high-grade gliomas, or metastases based on perfusion parameters. The cut off value of rCBV 1.64 can be used to differentiate between low grade and high grade gliomas. However, depending only on perfusion parameters, differentiation between the tumors like lymphomas, high-grade gliomas, and metastases may not be possible.
在CT扫描上鉴别颅内占位性病变具有挑战性。我们研究的目的是确定各种颅内占位性病变(ICSOL)的灌注参数,区分良性和恶性病变,并区分不同级别的胶质瘤。
我们对64例年龄在17至68岁之间、脑部有占位性病变的患者进行了CT灌注(CTP)检查,并计算了相对脑血流量(rCBF)和相对脑血容量(rCBV)。
我们发现,与高级别肿瘤、淋巴瘤和转移瘤相比,低级别胶质瘤的灌注明显较低。同样,在感染性病变中,与脑结核瘤(TOT)相比,结核性肉芽肿(TWT)和脑脓肿的灌注明显较低。在环形强化病变中,与脑脓肿、TOT和转移瘤相比,TWT的包膜灌注明显较低。
因此,总之,基于灌注参数可以将感染性病变与淋巴瘤、高级别胶质瘤或转移瘤等肿瘤区分开来。rCBV的截断值1.64可用于区分低级别和高级别胶质瘤。然而,仅依靠灌注参数,可能无法区分淋巴瘤、高级别胶质瘤和转移瘤等肿瘤。