Abstract
Purpose
This study was undertaken to correlate apparent diffusion coefficient (ADC) and relative regional cerebral blood volume (rrCBV) to histological findings in a large series of patients with primary or secondary brain tumours to evaluate diffusion-weighted (DWI) and perfusionweighted (PWI) imaging in the characterisation of cerebral tumors.
Materials and methods
Ninety-eight patients with cerebral tumours, 46 of which were primary (seven grade 0-I, nine low-grade gliomas, two gliomatosis cerebri, nine lymphomas and 19 high-grade gliomas) and 52 secondary, underwent conventional magnetic resonance (MR) imaging completed with DWI and dynamic contrast susceptibility PWI. Both ADC and rrCBV were calculated on a workstation by using Functool 2 software. Student’s t test was used to determine any statistically significant differences in the ADC and rrCBV values.
Results
Seventeen of 98 tumours were cystic or necrotic (12/17 hypointense and 5/17 hyperintense on DWI); the ADC value of hyperintense cystic areas was 0.97±0.23×10−3 mm2/s. The ADC value of solid tumours varied between 0.64 and 3.5×10−3 mm2/s. The rrCBV value was 1.4 (σ 0.66) in low-grade gliomas; 1.22 (σ 0.25) in lymphomas; 4.5 (σ 0.85) in grade III gliomas; 3.18 (σ 1.26) in grade IV gliomas and 2.53 (σ 1.6) in metastases.
Conclusions
DWI has an important role in the differential diagnosis of cystic cerebral masses but not in tumour characterisation. PWI is helpful in differentiating high-from low-grade gliomas and lymphomas from high-grade gliomas.
Riassunto
Obiettivo
Correlare i valori del coefficiente di diffusione apparente (ADC) e del volume cerebrale medio (rrCBV), ottenuti su un’ampia serie di pazienti con tumori cerebrali (primitivi o secondari), con il dato istologico per valutare l’apporto delle tecniche di diffusione (DWI) e perfusione (PWI) nella caratterizzazione dei tumori cerebrali.
Materiali e metodi
Novantotto pazienti con tumore cerebrale, 46 con tumore primitivo (7 di grado 0–I, 9 gliomi a basso grado, 2 gliomatosi cerebri, 9 linfomi, 19 gliomi ad alto grado) e 52 con metastasi sono stati sottoposti ad esame RM convenzionale completato da acquisizione DWI e da studio perfusionale ottenuto durante la somministrazione di un bolo di gadolinio. Su tutte le lesioni sono state effettuate rielaborazioni su una work-station per il calcolo dell’ADC e della rrCBV utilizzando il software “functool 2”. Sono state effettuate rielaborazioni statistiche utilizzando il test t di Student per dati non appaiati.
Risultati
Diciassette tumori erano costituiti da una componente centrale cistica che in 5 casi era iperintensa in DWI (valore medio ADC 0,97±0,23×10−3 mm2/s). L’ADC della parte solida dei tumori aveva valori compresi tra 0,64 e 3,5×10−3 mm2/s. L’rrCBV media è risultata di 1,4 (σ 0,66) nei gliomi a basso grado; 1,22 (σ 0,25) nei linfomi; 4,5 (σ 0,85) nei gliomi grado III; 3,18 (σ 1,26) nei gliomi grado IV e 2,53 (σ 1,6) nelle metastasi.
Conclusioni
Le acquisizioni DWI hanno un ruolo rilevante nella diagnosi delle masse cistiche, mentre non sembrano avere un ruolo nella caratterizzazione dei tumori. La PWI fornisce elementi utili nella diagnosi differenziale tra gliomi a basso ed alto grado e tra gliomi ad alto grado e linfomi.
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Rizzo, L., Crasto, S.G., Moruno, P.G. et al. Role of diffusion- and perfusion-weighted MR imaging for brain tumour characterisation. Radiol med 114, 645–659 (2009). https://doi.org/10.1007/s11547-009-0401-y
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DOI: https://doi.org/10.1007/s11547-009-0401-y