Bhatia Aashim, Lee Vincent Kyu, Qian Yongxian, Paldino Michael J, Ceschin Rafael, Hect Jasmine, Mountz James M, Sun Dandan, Kohanbash Gary, Pollack Ian F, Jakacki Regina I, Boada Fernando, Panigrahy Ashok
Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19096, USA.
Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
Diagnostics (Basel). 2022 May 13;12(5):1223. doi: 10.3390/diagnostics12051223.
Background: 23Na MRI correlates with tumor proliferation, and studies in pediatric patients are lacking. The purpose of the study: (1) to compare total sodium concentration (TSC) between pediatric glioma and non-neoplastic brain tissue using 23Na MRI; (2) compare tissue conspicuity of bound sodium concentration (BSC) using 23Na MRI dual echo relative to TSC imaging. Methods: TSC was measured in: (1) non-neoplastic brain tissues and (2) three types of manually segmented gliomas (diffuse intrinsic brainstem glioma (DIPG), recurrent supratentorial low-grade glioma (LGG), and high-grade glioma (HGG)). In a subset of patients, serial changes in both TSC and BSC (dual echo 23Na MRI) were assessed. Results: Twenty-six pediatric patients with gliomas (median age of 12.0 years, range 4.9−23.3 years) were scanned with 23Na MRI. DIPG treated with RT demonstrated higher TSC values than the uninvolved infratentorial tissues (p < 0.001). Recurrent supratentorial LGG and HGG exhibited higher TSC values than the uninvolved white matter (WM) and gray matter (GM) (p < 0.002 for LGG, and p < 0.02 for HGG). The dual echo 23Na MRI suppressed the sodium signal within both CSF and necrotic foci. Conclusion: Quantitative 23Na MRI of pediatric gliomas demonstrates a range of values that are higher than non-neoplastic tissues. Dual echo 23Na MRI of BCS improves tissue conspicuity relative to TSC imaging.
23Na磁共振成像（MRI）与肿瘤增殖相关，但儿科患者的相关研究尚缺。本研究目的：（1）使用23Na MRI比较儿科胶质瘤与非肿瘤性脑组织之间的总钠浓度（TSC）；（2）使用23Na MRI双回波相对于TSC成像比较结合钠浓度（BSC）的组织清晰度。方法：在以下组织中测量TSC：（1）非肿瘤性脑组织；（2）三种手动分割的胶质瘤（弥漫性脑桥内生性胶质瘤（DIPG）、复发性幕上低级别胶质瘤（LGG）和高级别胶质瘤（HGG））。在部分患者中，评估TSC和BSC（双回波23Na MRI）的系列变化。结果：26例患有胶质瘤的儿科患者（中位年龄12.0岁，范围4.9 - 23.3岁）接受了23Na MRI扫描。接受放疗的DIPG显示出比未受累的幕下组织更高的TSC值（p < 0.001）。复发性幕上LGG和HGG显示出比未受累的白质（WM）和灰质（GM）更高的TSC值（LGG为p < 0.002，HGG为p < 0.02）。双回波23Na MRI抑制了脑脊液和坏死灶内的钠信号。结论：儿科胶质瘤的定量23Na MRI显示出一系列高于非肿瘤组织的值。相对于TSC成像，BCS的双回波23Na MRI提高了组织清晰度。
