High grade gliomas: The role of dynamic contrast-enhanced susceptibility-weighted perfusion MRI and proton MR spectroscopic imaging in differentiating grade III from grade IV

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• 作者：Sayed Zidan^a ; Hazim I. Tantawy^a ; ; Mansour Abdelmagid Makia^b
• 关键词：MRS ; Dynamic contrast-enhanced perfusion MRI ; Glioma grade III ; Glioma grade IV
• 刊名：The Egyptian Journal of Radiology and Nuclear Medicine
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：47
• 期：4
• 页码：1565-1573
• 全文大小：2865 K

文摘

Advanced MR imaging techniques provide physiologic information which complements the conventional MRI findings.

Purpose

To evaluate the role of dynamic contrast-enhanced perfusion MRI and proton MR spectroscopy (MRS) in differentiating grade-III from grade-IV glioma.

Results

40 patients with preliminary diagnosis of glioma according to the conventional MRI study and the WHO classification and grading of glioma underwent dynamic MRI study which revealed, 19 patients (47.5%) are diagnosed as grade-III, and 21 cases (52.5%) are diagnosed as grade-IV. The tumor core relative cerebral blood volume (rCBV) was highly significant (P = 0.000) in differentiating grade III from grade IV with cutoff value of 6,sensitivity of 90.5%, specificity of 68.4%, PVP of 76% and NPV of 86.7%.

In proton MR spectroscopy, (CHo/Cr) ratio was significant in differentiating grade III from grade IV glioma (P = 0.02), while CHo/NAA, NAA/Cr and MI/Cr ratios were not significant.

Conclusion

The rCBV estimation and the metabolite ratios separately or in combination increase the sensitivity of grading of glioma rather than the conventional MRI.