Chakravorty Ananya, Steel Timothy, Chaganti Joga
St Vincent's Clinical School, University of New South Wales, Sydney, Australia
Department of Neurosurgery, St Vincent's Hospital, Sydney, Australia.
Neuroradiol J. 2015 Dec;28(6):574-83. doi: 10.1177/1971400915611916. Epub 2015 Oct 16.
Conventional magnetic resonance imaging (MRI) is the technique of choice for diagnosis of cerebral tumours, and has become an increasingly powerful tool for their evaluation; however, the diagnosis of common contrast-enhancing lesions can be challenging, as it is sometimes impossible to differentiate them using conventional imaging. Histopathological analysis of biopsy specimens is the gold standard for diagnosis; however, there are significant risks associated with the invasive procedure and definitive diagnosis is not always achieved. Early accurate diagnosis is important, as management differs accordingly. Advanced MRI techniques have increasing utility for aiding diagnosis in a variety of clinical scenarios. Dynamic susceptibility-weighted contrast-enhanced (DSC) MRI is a perfusion imaging technique and a potentially important tool for the characterisation of cerebral tumours. The percentage of signal intensity recovery (PSR) and relative cerebral blood volume (rCBV) derived from DSC MRI provide information about tumour capillary permeability and neoangiogenesis, which can be used to characterise tumour type and grade, and distinguish tumour recurrence from treatment-related effects. Therefore, PSR and rCBV potentially represent a non-invasive means of diagnosis; however, the clinical utility of these parameters has yet to be established. We present a review of the literature to date.
传统磁共振成像(MRI)是诊断脑肿瘤的首选技术,并且已成为评估脑肿瘤的一种越来越强大的工具;然而,对于常见的强化病变的诊断可能具有挑战性,因为有时使用传统成像无法区分它们。活检标本的组织病理学分析是诊断的金标准;然而,该侵入性操作存在重大风险,并且并不总是能实现明确诊断。早期准确诊断很重要,因为治疗方法会相应不同。先进的MRI技术在各种临床场景中对辅助诊断的作用越来越大。动态磁敏感对比增强(DSC)MRI是一种灌注成像技术,是表征脑肿瘤的潜在重要工具。从DSC MRI得出的信号强度恢复百分比(PSR)和相对脑血容量(rCBV)提供了有关肿瘤毛细血管通透性和新生血管形成的信息,可用于表征肿瘤类型和分级,并区分肿瘤复发与治疗相关效应。因此,PSR和rCBV可能代表一种非侵入性诊断方法;然而,这些参数的临床实用性尚未确立。我们对迄今为止的文献进行了综述。