High-grade gliomas and solitary metastases: Differentiation by using perfusion and proton spectroscopic MR Imaging

被引:388
作者
Law, M
Cha, S
Knopp, EA
Johnson, G
Arnett, J
Litt, AW
机构
[1] NYU, Med Ctr, Dept Radiol, New York, NY 10016 USA
[2] NYU, Med Ctr, Dept Neurosurg, New York, NY 10016 USA
关键词
brain neoplasms; diagnosis; MR; secondary; magnetic resonance (MR); spectroscopy; perfusion study;
D O I
10.1148/radiol.2223010558
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To determine whether perfusion-weighted and proton spectroscopic MR imaging can be used to differentiate high-grade primary gliomas and solitary metastases on the basis of differences in vascularity and metabolite levels in the peritumoral region. MATERIALS AND METHODS: Fifty-one patients with a solitary brain tumor (33 gliomas, 18 metastases) underwent conventional, contrast material-enhanced perfusion-weighted, and proton spectroscopic MR imaging before surgical resection or stereotactic biopsy. Of the 33 patients with gliomas, 22 underwent perfusion-weighted MR imaging; nine, spectroscopic MR imaging; and two underwent both. Of the 18 patients with metastases, 12 underwent perfusion-weighted MR imaging, and six, spectroscopic MR imaging. The peritumoral region was defined as the area in the white matter immediately adjacent to the enhancing (hyperintense on T2-weighted images, but not enhancing on postcontrast T1-weighted images) portion of the tumor. Relative cerebral blood volumes in these regions were calculated from perfusion-weighted MR data. Spectra from the enhancing tumor, the peritumoral region, and normal brain were obtained from the two-dimensional spectroscopic MR acquisition. The Student t test was used to determine if there was a statistically significant difference in relative cerebral blood volume and metabolic ratios between high-grade gliomas and metastases. RESULTS: The measured relative cerebral blood volumes in the peritumoral region in high-grade gliomas and metastases were 1.31 +/- 0.97 (mean +/- SD) and 0.39 +/- 0.19, respectively. The difference was statistically significant (P < .001). Spectroscopic imaging demonstrated elevated choline levels (choline-to-creatine ratio was 2.28 ± 1.24) in the peritumoral region of gliomas but not in metastases (choline-to-creatine ratio was 0.76 ± 0.23). The difference was statistically significant (P = .001). CONCLUSION: Although conventional MR imaging characteristics of solitary metastases and primary high-grade gliomas may sometimes be similar, perfusion-weighted and spectroscopic MR imaging enable distinction between the two. (C) RSNA, 2002.
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收藏
页码:715 / 721
页数:7
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