Yamashita Koji, Togao Osamu, Kikuchi Kazufumi, Kuga Daisuke, Sangatsuda Yuhei, Fujioka Yutaka, Kinoshita Izumi, Obara Makoto, Yoshimoto Koji, Ishigami Kousei
Department of Radiology Informatics and Network, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
Neuroradiology. 2023 Sep;65(9):1415-1418. doi: 10.1007/s00234-023-03186-x. Epub 2023 Jun 27.
This study aimed to investigate whether arterial spin labeling (ASL) features allow differentiation of oligodendroglioma, IDH-mutant and 1p/19q-codeleted (IDHm-codel) from diffuse glioma with IDH-wildtype (IDHw) or astrocytoma, IDH-mutant (IDHm-noncodel). Participants comprised 71 adult patients with pathologically confirmed diffuse glioma, classified as IDHw, IDHm-noncodel, or IDHm-codel. Subtraction images were generated from paired-control/label images on ASL and used to assess the presence of a cortical high-flow sign. The cortical high-flow sign was defined as increased ASL signal intensity within the tumor-affecting cerebral cortex compared with normal-appearing cortex. Regions without contrast enhancement on conventional MR imaging were targeted. The frequency of the cortical high-flow sign on ASL was compared among IDHw, IDHm-noncodel, and IDHm-codel. As a result, the frequency of the cortical high-flow sign was significantly higher for IDHm-codel than for IDHw or IDHm-noncodel. In conclusion, the cortical high-flow sign could represent a hallmark of oligodendroglioma, IDH-mutant, and 1p/19q-codeleted without intense contrast enhancement.
本研究旨在探讨动脉自旋标记（ASL）特征是否能够区分少突胶质细胞瘤、异柠檬酸脱氢酶（IDH）突变型和1p/19q共缺失型（IDHm-codel）与异柠檬酸脱氢酶野生型（IDHw）弥漫性胶质瘤或IDH突变型（IDHm-noncodel）星形细胞瘤。研究对象包括71例经病理证实的弥漫性胶质瘤成年患者，分为IDHw、IDHm-noncodel或IDHm-codel组。从ASL的配对对照/标记图像生成减影图像，用于评估皮质高血流征的存在。皮质高血流征定义为与外观正常的皮质相比，肿瘤累及的大脑皮质内ASL信号强度增加。以常规磁共振成像上无强化的区域为目标。比较IDHw、IDHm-noncodel和IDHm-codel组ASL上皮质高血流征的出现频率。结果显示，IDHm-codel组皮质高血流征的出现频率显著高于IDHw组或IDHm-noncodel组。总之，皮质高血流征可能代表少突胶质细胞瘤、IDH突变型和1p/19q共缺失型的一个特征，且无明显强化。
