Villanueva-Meyer J E, Barajas R F, Mabray M C, Chen W, Shankaranarayanan A, Koon P, Barani I J, Tihan T, Cha S
Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.
Department of Diagnostic Radiology, Oregon Health and Science University, Portland, OR, USA; Advanced Imaging Research Center, Oregon Health and Science University, Portland, OR, USA.
Eur J Radiol. 2017 Jun;91:88-92. doi: 10.1016/j.ejrad.2017.03.022. Epub 2017 Mar 30.
Cerebral edema associated with brain tumors is an important source of morbidity. Its type depends largely on the capillary ultra-structures of the histopathologic subtype of underlying brain tumor. The purpose of our study was to differentiate vasogenic edema associated with brain metastases and infiltrative edema related to diffuse gliomas using quantitative 3D T1 rho (T1ρ) imaging.
Preoperative MR examination including whole brain 3D T1ρ imaging was performed in 23 patients with newly diagnosed brain tumors (9 with metastasis, 8 with lower grade glioma, LGG, 6 with glioblastoma, GBM). Mean T1ρ values were measured in regions of peritumoral non-enhancing T2 signal hyperintensity, excluding both enhancing and necrotic or cystic component, and normal-appearing white matter.
Mean T1ρ values were significantly elevated in the vasogenic edema surrounding intracranial metastases when compared to the infiltrative edema associated with either LGG or GBM (p=0.02 and <0.01, respectively). No significant difference was noted between T1ρ values of infiltrative edema between LGG and GBM (p=0.84 and 0.96, respectively).
Our study demonstrates the feasibility and potential diagnostic role of T1ρ in the quantitative differentiation between edema related to intracranial metastases and gliomas and as a potentially complementary tool to standard MR techniques in further characterizing pathophysiology of vasogenic and infiltrative edema.
与脑肿瘤相关的脑水肿是发病的一个重要来源。其类型很大程度上取决于潜在脑肿瘤组织病理学亚型的毛细血管超微结构。我们研究的目的是使用定量三维T1ρ（T1ρ）成像来区分与脑转移瘤相关的血管源性水肿和与弥漫性胶质瘤相关的浸润性水肿。
对23例新诊断的脑肿瘤患者（9例转移瘤、8例低级别胶质瘤、6例胶质母细胞瘤）进行术前磁共振检查，包括全脑三维T1ρ成像。在瘤周非强化T2信号高强化区域测量平均T1ρ值，不包括强化、坏死或囊性成分以及外观正常的白质。
与低级别胶质瘤或胶质母细胞瘤相关的浸润性水肿相比，颅内转移瘤周围血管源性水肿的平均T1ρ值显著升高（分别为p = 0.02和<0.01）。低级别胶质瘤和胶质母细胞瘤的浸润性水肿T1ρ值之间无显著差异（分别为p = 0.84和0.96）。
我们的研究证明了T1ρ在定量区分颅内转移瘤和胶质瘤相关水肿方面的可行性和潜在诊断作用，并且作为一种潜在的补充工具，可用于进一步表征血管源性和浸润性水肿的病理生理学，辅助标准磁共振技术。
