Cha J, Kim S T, Nam D-H, Kong D-S, Kim H-J, Kim Y K, Kim H Y, Park G M, Jeon P, Kim K H, Byun H S
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, 135-710, Seoul, Republic of Korea.
Cardiovascular and Stroke Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Clin Neuroradiol. 2017 Sep;27(3):329-334. doi: 10.1007/s00062-016-0508-1. Epub 2016 Mar 7.
The aim of this study was to differentiate hemangioblastomas from metastatic brain tumors using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and compare the diagnostic performances with diffusion-weighted imaging (DWI) and dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI).
We retrospectively reviewed 7 patients with hemangioblastoma and 15 patients with metastatic adenocarcinoma with magnetic resonance imaging (MRI) including DWI, DSC-MRI, and DCE-MRI. Apparent diffusion coefficient (ADC), relative cerebral blood volume (rCBV), and DCE-MRI parameters (K , k , v , and v ) were compared between the two groups. The diagnostic performance of each parameter was evaluated with receiver operating characteristic (ROC) curve analysis.
v , k , and rCBV were significantly different between patients with hemangioblastoma and those with metastatic brain tumor (p < 0.001, p = 0.005, and p = 0.017, respectively). A v cutoff value of 0.012 and a rCBV cutoff value of 8.0 showed the highest accuracy for differentiating hemangioblastoma from metastasis. The area under the ROC curve for v and rCBV was 0.99 and 0.89, respectively. A v > 0.012 showed 100 % sensitivity, 93.3 % specificity, and 95.5 % accuracy and a rCBV > 8.0 showed 85.7 % sensitivity, 93.3 % specificity, and 90.9 % accuracy for differentiating hemangioblastoma from metastatic brain tumor.
DCE-MRI was useful for differentiating hemangioblastoma from metastatic brain tumor.
本研究旨在利用动态对比增强磁共振成像（DCE-MRI）鉴别血管母细胞瘤与脑转移瘤，并将其诊断性能与扩散加权成像（DWI）和动态磁敏感对比磁共振成像（DSC-MRI）进行比较。
我们回顾性分析了7例血管母细胞瘤患者和15例转移性腺癌患者的磁共振成像（MRI）资料，包括DWI、DSC-MRI和DCE-MRI。比较了两组之间的表观扩散系数（ADC）、相对脑血容量（rCBV）以及DCE-MRI参数（Ktrans、kep、ve和vp）。采用受试者操作特征（ROC）曲线分析评估各参数的诊断性能。
血管母细胞瘤患者与脑转移瘤患者之间的ve、kep和rCBV存在显著差异（分别为p < 0.001、p = 0.005和p = 0.017）。ve截断值为0.012和rCBV截断值为8.0时，鉴别血管母细胞瘤与转移瘤的准确性最高。ve和rCBV的ROC曲线下面积分别为0.99和0.89。ve > 0.012时，鉴别血管母细胞瘤与脑转移瘤的敏感性为100%、特异性为93.3%、准确性为95.5%；rCBV > 8.0时，敏感性为85.7%、特异性为93.3%、准确性为90.9%。
DCE-MRI有助于鉴别血管母细胞瘤与脑转移瘤。
