The Usefulness of Perfusion MR Imaging in Patients with Brain Tumors

Cho, Young Min; Ko, Eun Hye; Jeong, Gwang Woo; Seo, Jeong Jin; Kim, Yun Hyeon; Jeong, Young Yeon; Chung, Tae Woong; Kim, Jae Kye

Abstract

PURPOSE: To determine the usefulness of perfusion weighted MR imaging in the assessment of relative cerebral blood volume(rCBV) in brain tumors.
MATERIALS AND METHODS
Twenty-three patients with primary or metastatic brain tumors [nine gliomas (6 high grade and 3 low), six metastatic tumors, five meningiomas (4 benign and 1 atypical), two neurilemmomas and one hemangioblastoma] underwent perfusion-weighted and conventional MR imaging. A total of 240 perfusion MR images were obtained from four axial slices after rapid injection of contrast media using a gradient echo planar imaging pulse sequence, and this was followed by postprocessing of these images to give CBV maps. In order to calculate the rCBV of tumor to normal white matter, ROIs were defined on the CBV map of a tumor and its contralateral normal white matter.
RESULTS
The rCBV ratio of tumors to contralateral normal side was as follows: high-grade glioma, 0.40-5.64(mean +/-SD = 2.91 0.95); low grade astrocytoma, 0.77 -1.66 (mean +/-SD = 1.15 +/-0.28); benign menin-gioma,2.06 -4.90 (mean +/-SD = 3.59 +/-0.84); atypical meningioma, 0.46 -1.18 (mean +/-SD = 0.72 +/-0.25); neurilemmoma, 1.45 -3.85 (mean +/-SD = 2.56 +/-0.92); and hemangioblastoma, 6.16 -8.35 (mean +/-SD = 7.02 +/-1.12). High grade gliomas were more hypervascular than low grade astrocytomas, and showed a variable range of relative cerebral blood volume. In metaststic cancer, CBV maps showed a relatively high and variable blood volume. Benign meningiomas exhibited high relative cerebral blood volume, while in the atypical meningioma with cystic degeneration, this volume was low. In neurilemmomas, a variable range of relative cerebral blood volume, was noted, while in the mural nodule of the hemangioblastoma, this volume was the highest.
CONCLUSION
Perfusion-weighted MRI indicated the rCBV of various brain tumor lesions, and this suggests that the modality can provide a very useful means of assessing brain tumor vascularity.