Mohamedbaqer Easa Ahmed, Sahib Mohanad, Ghanaati Hosein, Taghiloo Aidin, Shakoba Madjid
Department of Radiology Technology, College of Health and Medical Technologies, Al-Ayen Iraqi University, Thi-Qar, IRQ.
Department of Radiological Techniques, College of Health and Medical Techniques, Al-Mustaqbal University, Babylon, IRQ.
Cureus. 2025 Jul 29;17(7):e89006. doi: 10.7759/cureus.89006. eCollection 2025 Jul.
Purpose To enhance diagnostic accuracy by incorporating relative cerebral blood flow (rCBF) as an additional parameter to dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) variables, thereby enabling the differentiation between radionecrosis and recurrent brain tumours. Materials and methods This study involved 54 patients who had previously undergone treatment for primary cerebral tumours. All participants received radiotherapy and underwent both conventional MRI and DSC-PWI. MRI scans were performed using a 1.5 T closed MRI scanner (MAGNETOM Aera, Siemens Healthineers, Erlangen, Germany), equipped with a 16-channel Head/Neck coil for image acquisition. Several perfusion variables were calculated from DSC-PWI, including rCBF, relative cerebral blood volume (rCBV), relative peak height (rPH), and relative percentage of signal intensity recovery (rPSR). Statistical analyses included ANOVA and receiver operating characteristic (ROC) curve analysis, with histopathological findings used as the reference standard for diagnostic correlation. Results A total of 38 patients (38/54, 70.4%) were diagnosed with tumour recurrence (TR), while 16 patients (16/54, 29.6%) were diagnosed with radionecrosis. The values of rCBF, rCBV, rPSR, and rPH were significantly higher ( < 0.05) in recurrent tumours compared to radionecrosis lesions. At a cutoff value of ≥1.42, rCBF demonstrated a sensitivity of 0.95 and a specificity of 0.94. The area under the curve (AUC) for rCBF peaked at approximately 0.97, surpassing other parameters: rCBV (0.948), rPSR (0.069), and rPH (0.871). Conclusion DSC-PWI is a diagnostic tool that helps differentiate between TR and radionecrosis using several variables, the most important of which is rCBF.
目的 通过将相对脑血流量(rCBF)作为动态磁敏感对比灌注加权成像(DSC-PWI)变量的附加参数来提高诊断准确性,从而实现放射性坏死与复发性脑肿瘤的鉴别。材料与方法 本研究纳入54例曾接受原发性脑肿瘤治疗的患者。所有参与者均接受了放疗,并进行了常规MRI和DSC-PWI检查。MRI扫描使用1.5T封闭式MRI扫描仪(MAGNETOM Aera,西门子医疗,德国埃尔朗根),配备16通道头颈线圈进行图像采集。从DSC-PWI中计算出多个灌注变量,包括rCBF、相对脑血容量(rCBV)、相对峰值高度(rPH)和信号强度恢复相对百分比(rPSR)。统计分析包括方差分析和受试者操作特征(ROC)曲线分析,以组织病理学结果作为诊断相关性的参考标准。结果 共有38例患者(38/54,70.4%)被诊断为肿瘤复发(TR),16例患者(16/54,29.6%)被诊断为放射性坏死。与放射性坏死病变相比,复发性肿瘤的rCBF、rCBV、rPSR和rPH值显著更高(<0.05)。在截断值≥1.42时,rCBF的敏感性为0.95,特异性为0.94。rCBF的曲线下面积(AUC)峰值约为0.97,超过其他参数:rCBV(0.948)、rPSR(0.069)和rPH(0.871)。结论 DSC-PWI是一种诊断工具,可通过多个变量帮助鉴别TR和放射性坏死,其中最重要的是rCBF。