Combined Study of Susceptibility Weighted Imaging and Dynamical Susceptibility Contrasted Perfusion Imaging in Detection of Heterogeneity of Brain Neoplasms
|School||Dalian Medical University|
|Course||Medical Imaging and Nuclear Medicine|
|Keywords||brain neoplasms heterogeneity susceptibility weighted imaging dynamical susceptibility contrasted perfusion imaging|
Objective:To measure the susceptibility、perfusion data and microbleed and vessles of the brain masses by combined susceptibility weighted imaging(SWI) and perfusion weighted imaging(PWI),to be further analyzed for reasonable explaining the pathophysiology of the heterogeneity of brain neoplasms.Meterials and Methods:Patients received Enhanced T2 star weighted angiography (ESWAN)and Dynamical susceptibility contrasted perfusion imaging.(DSC-PI) at GE Signa HDxt 3.0T MR, used standard head coil .There were 28 males,15 females, age 17-75,average 57.91±12.88 years,clinically proven brain tumors,including 24 metastatics, 9 patients with grades III–IV gliomas(grade IV,6;gradeIII,3),10 meningiomas were diagnosed with surgical specimens. MR protocols included sagittal FSE T1WI、axial FSE T1WI , T2WI, GRE ESWAN、DSC-PI and postgadolinium T1-weighted. All raw data of ESWAN and DSC-PI were post-processed by software Functool in AW4.3.The flitered phase image(FPI), minium intensity projection(ESWAN MinIP),regional cerebral blood volume(CBV)map, regional cerebral blood flow(rCBF)map and regional mean transit time(rMTT) map were respectively obtained .After determining the location and realm of the solid tumors lesions, the phase、R2*、rCBV、rCBF and rMTT value of the affected matter were measured. The blood products and vessels were observed respectively on ESWAN MinIP,the images of all sequences were scored from I to III. The differences between phase、R2*、rCBV、rCBF and rMTT values were tested by one—way ANOVA in SPSS 16.0 software. The blood products and vessels were tested by Wilconxon rank test and the correlations of all data were also analyzed by Spearman correlation analysis. Results:1. The Phase and R2* value of glioma Comparied with the normal tissue ,Phase value of the metastatics and meningiomas differed significantly(0.103±0.033,0.034±0.004,P=0.003;0.097±0.043,0.046±0.019,P=0.012);Furthernore, R2* value of these two groups also differed significantly(15.099±5.541,19.528±1.580,P=0.003;15.380±4.609,18.753±1.571,P=0.027). The Phase and R2* value of glioma showed no significant differenc(e0.086±0.059, 0.005±0.075,P=0.229;15.380±4.609,18.502±2.071, P=0.368). Phase and R2* value of the three groups showed no significant difference(P=0.932,0.171).2.Vessles and hemorrhage of tumors According to the hemorrhage scorses,there were 5 metastatics grade I(24%),6 grade II(29%),4 grade III(57%);there were 5 glioma grade I(11%),1grade II(11%),7 grade III(78%).there were 1 meningioma grade I(50%),1grade II(25%),7 grade III(25%).According to the hemorrhage scores,there were 11 metastatics grade I(52%),2 grade I(I10%),8 grade II(I38%);there were 5 glioma grade I(56%),1grade I(I11%),3 grade III(33%).there were 6 meningioma grade I(75%),2grade III(25%).Statistical comparison showed that the scores of vessels and microhemorrhage of gliomas and meningiomas in ESWANMinIP, differed significantly (P<0.05). The scores between metastatics and the other two groups showed no significant difference (P>0.05). .Comma low intensity appeared in 4 metastatics(19%),1 glioma(11%)and 4 meningiomas(50%).3. To evaluate the microcirculation of the tumor Comparied with the normal tissue , rCBV and rCBF value of metastatics were higher than the normal tissue(1183.35±819.64,265.98±68.59,P=0.001;3.64±2.14,0.84±0.09,P=0.001).rCBV value of the meningiomas were also higher than the normal tissue ( 904.37±910.64, 219.25±69.94,P=0.023).The rCBV ,rCBF and rMTT value of the three groups showed no significant difference(P>0.05).4.The analysis of the correlations between SWI and DSC-PI The significantly negative correlations occurred between R2* value and the scores of vessels in the tumor(r=-0.444,P=0.050).There were no correlations between the perfusion parameters and R2*、Phase、scores of small vessels and microhemorrhage(P>0.05). Conclusion:1. ESWAN and DSC-PI are more sensitive and superior at showing the blood products and vessles of brain neoplasms, which can evaluate the heterogeneity of the brain neoplasms and provide more information of the pathology of the tumor..2. Phase and R2*value can reflect the oxygen、iron and water content in tumors ,which were helpful in diagnosis of the mircoenvironment of the tumors.3. Metastatics and gliomas had rich vessles and more likely to hemorrhage.There were positive correlations between the scores of vessels and hemorrhage .4. rCBV and rCBF can reflect the blood volume of the tumors. Metastaticsand , meningiomas and gliomas had higher blood perfusion than the nomal tissue.