Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands.
Fortis Memorial Research Institute, Gurgaon, India.
J Magn Reson Imaging. 2018 Jun;47(6):1616-1625. doi: 10.1002/jmri.25869. Epub 2017 Sep 30.
Glioma grade along with patient's age and general health are used for treatment planning and prognosis.
To characterize and quantify the spontaneous blood oxygen level-dependent (BOLD) fluctuations in gliomas using measures based on T2*-weighted signal time-series and to distinguish between high- and low-grade gliomas.
Retrospective.
Twenty-one patients with high-grade and 13 patients with low-grade gliomas confirmed on histology were investigated.
FIELD STRENGTH/SEQUENCE: Dynamic T2*-weighted (multislice single-shot echo-planar-imaging) magnetic resonance imaging (MRI) was performed on a 3T system with an 8-element receive-only head coil to measure the BOLD fluctuations. In addition, a dynamic T -weighted (3D fast field echo) dynamic contrast-enhanced (DCE) perfusion scan was performed.
Three BOLD measures were determined: the temporal shift (TS), amplitude of low frequency fluctuations (ALFF), and regional homogeneity (ReHo). DCE perfusion-based cerebral blood volume (CBV) and time-to-peak (TTP) maps were concurrently evaluated for comparison.
An analysis-of-variance test was first used. When the test appeared significant, post-hoc analysis was performed using analysis-of-covariance with age as covariate. Logistic regression and receiver-operator characteristic curve analysis were also performed.
TS was significantly advanced in high-grade gliomas compared to the contralateral cortex (P = 0.01) and low-grade gliomas (P = 0.009). In high-grade gliomas, ALFF and CBV were significantly higher than the contralateral cortex (P = 0.041 and P = 0.008, respectively) and low-grade gliomas (P = 0.036 and P = 0.01, respectively). ReHo and TTP did not show significant differences between high- and low-grade gliomas (P = 0.46 and P = 0.42, respectively). The area-under-curve was above 0.7 only for the TS, ALFF, and CBV measures.
Advanced and amplified hemodynamic fluctuations manifest in high-grade gliomas, but not in low-grade gliomas, and can be assessed using BOLD measures. Preliminary results showed that quantification of spontaneous fluctuations has potential for hemodynamic characterization of gliomas and distinguishing between high- and low-grade gliomas.
4 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;47:1616-1625.
胶质母细胞瘤的分级以及患者的年龄和整体健康状况用于治疗计划和预后。
使用基于 T2*-加权信号时间序列的测量方法来描述和量化胶质母细胞瘤中的自发血氧水平依赖（BOLD）波动，并区分高级别和低级别胶质母细胞瘤。
回顾性。
21 例高级别和 13 例低级别经组织学证实的胶质母细胞瘤患者接受了研究。
磁场强度/序列： 在 3T 系统上使用 8 通道接收线圈进行动态 T2*-加权（多层面单次激发回波平面成像）磁共振成像（MRI），以测量 BOLD 波动。此外，还进行了动态 T1 加权（3D 快速场回波）动态对比增强（DCE）灌注扫描。
确定了三个 BOLD 指标：时移（TS）、低频波动幅度（ALFF）和局部一致性（ReHo）。同时评估了 DCE 灌注基于脑血容量（CBV）和达峰时间（TTP）图进行比较。
首先使用方差分析检验。当检验结果显著时，使用以年龄为协变量的协方差分析进行事后分析。还进行了逻辑回归和受试者工作特征曲线分析。
高级别胶质母细胞瘤的 TS 明显高于对侧皮质（P=0.01）和低级别胶质母细胞瘤（P=0.009）。在高级别胶质母细胞瘤中，ALFF 和 CBV 明显高于对侧皮质（P=0.041 和 P=0.008）和低级别胶质母细胞瘤（P=0.036 和 P=0.01）。高级别和低级别胶质母细胞瘤之间的 ReHo 和 TTP 没有显著差异（P=0.46 和 P=0.42）。只有 TS、ALFF 和 CBV 指标的曲线下面积大于 0.7。
高级别胶质母细胞瘤中存在先进和放大的血液动力学波动，但低级别胶质母细胞瘤中不存在，并且可以使用 BOLD 指标进行评估。初步结果表明，自发波动的定量分析具有对胶质母细胞瘤的血液动力学特征进行描述并区分高级别和低级别胶质母细胞瘤的潜力。
4 级技术功效：第 5 阶段 J. Magn. Reson. Imaging 2018;47:1616-1625.
