Department of Neuroradiology, University Hospital Schleswig-Holstein (UKSH), Luebeck, Germany.
Department of Neurosurgery, University Hospital Schleswig-Holstein (UKSH), Luebeck, Germany.
Jpn J Radiol. 2024 Oct;42(10):1146-1156. doi: 10.1007/s11604-024-01602-7. Epub 2024 May 31.
PURPOSE: To investigate glymphatic system function in patients with brain tumors, including both primary and secondary tumors, using diffusion tensor imaging along perivascular spaces (DTI-ALPS). METHODS: We retrospectively analyzed the MR DTI of 24 patients with unilateral brain tumors and compared them with age and sex-matched controls. We compared the DTI-ALPS index of the ipsi- and contralateral brain hemispheres. The region of interest was placed in the periventricular vessels adjacent to the lateral ventricles. Differences between sex, age, and kind of tumor (primary or brain metastasis) were evaluated. Correlations between DTI-ALPS index and age and the tumor's apparent diffusion coefficient (ADC) were also investigated. RESULTS: The DTI-ALPS index was significantly lower (p < 0.05) in the tumor-affected hemisphere (mean = 1.26 ± 0.24) than contralateral (mean = 1.43 ± 0.28). A comparison with healthy controls revealed no significant difference on the matched ipsilateral side. However, the DTI-ALPS index of the contralateral side of the patients was larger than the HC. Additionally, no statistically significant differences were found when analyzing the DTI-ALPS index vs. age, sex, and tumor entity. Additionally, we did not find a correlation between the DTI-ALPS index and patient age or tumor ADC. CONCLUSION: The decreased DTI-ALPS index in the tumor-affected hemisphere may be related to impaired glymphatic system function. However, cancer is often a systemic disease; thus, the DTI-ALPS index from the contralateral brain hemisphere may not generally be considered as a normal control. Nonetheless, the DTI-ALPS index does not only reflect diffusion in the perivascular spaces but it can also be influenced by factors such as axonal degeneration. Therefore, it does not directly reflect brain waste clearance and changes in the index should be interpreted carefully.
目的:使用血管周围空间(DTI-ALPS)扩散张量成像(DTI)研究脑肿瘤患者(包括原发性和继发性肿瘤)的糖质系统功能。
方法:我们回顾性分析了 24 例单侧脑肿瘤患者的磁共振 DTI,并将其与年龄和性别匹配的对照组进行比较。我们比较了双侧半球的 DTI-ALPS 指数。感兴趣区域放置在毗邻侧脑室的室周血管。评估了肿瘤的性别、年龄和类型(原发性或脑转移)的差异。还研究了 DTI-ALPS 指数与年龄和肿瘤表观扩散系数(ADC)之间的相关性。
结果:肿瘤受累半球的 DTI-ALPS 指数(mean = 1.26 ± 0.24)明显低于对侧(mean = 1.43 ± 0.28)(p < 0.05)。与健康对照组相比,同侧无显著差异。然而,患者对侧的 DTI-ALPS 指数大于 HC。此外,在分析 DTI-ALPS 指数与年龄、性别和肿瘤实体时,没有发现统计学差异。此外,我们没有发现 DTI-ALPS 指数与患者年龄或肿瘤 ADC 之间的相关性。
结论:肿瘤受累半球的 DTI-ALPS 指数降低可能与糖质系统功能受损有关。然而,癌症通常是一种全身性疾病;因此,对侧大脑半球的 DTI-ALPS 指数通常不能被视为正常对照。尽管如此,DTI-ALPS 指数不仅反映了血管周围空间的扩散,还可能受到轴突退化等因素的影响。因此,它不能直接反映脑废物清除,指数的变化应谨慎解释。
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