Department of Radiology, Ankara Sincan Educational and Research Hospital, Ankara, Turkey.
Department of Radiology, Bilkent City Hospital, Ankara, Turkey.
Acta Radiol. 2024 Jul;65(7):800-807. doi: 10.1177/02841851241256781. Epub 2024 May 26.
The accurate differentiation of primary central nervous system lymphoma (PCNSL) from glioblastoma multiforme (GBM) is clinically crucial due to the different treatment strategies between them.
To define magnetic resonance imaging (MRI) perfusion findings in PCNSL to make a safe distinction from GBM with dynamic contrast-enhanced (DCE) T1 and DSC T2 MRI perfusion findings.
This retrospective analysis included 19 patients with histopathologically diagnosed PCNSL and 21 individuals with GBM. DCE T1 vascular permeability perfusion values including K-trans, Ve, Kep, IAUGC, and DSC T2 perfusion values including cerebral blood volume (CBV) and cerebral blood flow (CBF) in axial sections from the pathological lesion and contralateral normal brain parenchyma were measured quantitatively using region of interest analysis.
The study observed no statistically significant difference between patients with PCNSL (T/B cell) and GBM in the median values of DCE T1 perfusion ratios ( > 0.05). Nevertheless, the DSC T2 perfusion ratios showed a substantial distinction between the two groups. In contrast to patients with PCNSL (1.185 vs. 1.224, respectively), those with GBM had higher median levels of r-CBV and r-CBF (2.898 vs. 2.467, respectively; 0.01). A cutoff value of ≤1.473 for r-CBV (Lesion/N) and ≤1.6005 for r-CBF (Lesion/N) was found to estimate the positivity of PCNSL.
DSC T2 MRI perfusion values showed lower r-CBV and r-CBF values in PCNSL patients compared to GBM patients. According to the findings, r-CBV and r-CBF are the most accurate MRI perfusion parameters for distinguishing between PCSNL and GBM.
原发性中枢神经系统淋巴瘤（PCNSL）与多形性胶质母细胞瘤（GBM）的准确区分在临床上至关重要，因为它们的治疗策略不同。
通过动态对比增强（DCE）T1 和 DSC T2 MRI 灌注成像来定义 PCNSL 的磁共振成像（MRI）灌注表现，以安全地区分 PCNSL 与 GBM。
本回顾性分析纳入了 19 例经组织病理学诊断为 PCNSL 的患者和 21 例 GBM 患者。使用感兴趣区分析对轴向切片中的 DCE T1 血管通透性灌注值（包括 K-trans、Ve、Kep、IAUGC）和 DSC T2 灌注值（包括脑血容量 [CBV] 和脑血流 [CBF]）进行定量测量。
研究发现，PCNSL（T/B 细胞）患者与 GBM 患者的 DCE T1 灌注比值中位数无统计学差异（>0.05）。然而，两组间 DSC T2 灌注比值存在显著差异。与 PCNSL 患者（分别为 1.185 和 1.224）相比，GBM 患者的 r-CBV 和 r-CBF 中位数水平更高（分别为 2.898 和 2.467； 0.01）。发现 r-CBV（病灶/正常）≤1.473 和 r-CBF（病灶/正常）≤1.6005 为 PCNSL 阳性的截断值。
与 GBM 患者相比，PCNSL 患者的 DSC T2 MRI 灌注值的 r-CBV 和 r-CBF 值较低。根据这些发现，r-CBV 和 r-CBF 是区分 PCSNL 和 GBM 的最准确的 MRI 灌注参数。
