J Korean Soc Magn Reson Med.  2011 Aug;15(2):102-109. 10.13104/jksmrm.2011.15.2.102.

Pre-operative Evaluation of Consistency in Intra-axial Brain Tumor with Diffusion-weighted Images (DWI) and Conventional MR Images

• Oh MS
• Ahn KJ
• Choi HS
• Jung SL
• Lee YJ
• Kim BS

• KMID: 2000058
• DOI: http://doi.org/10.13104/jksmrm.2011.15.2.102

Abstract

PURPOSE
To retrospectively evaluate the usefulness of diffusion-weighted images, ADC maps and conventional MR images for determination of brain tumor consistency.
MATERIALS AND METHODS
Twenty-three patients with brain tumor underwent MR examinations with T1, T2 and diffusion-weighted images. Regions of interest (ROIs) were drawn in the tumors, and the measured signal intensities (SI) were normalized with the contralateral side. We evaluated the correlation between SI ratios from various images and tumor consistency assessed at surgery. In three patients with both cystic and solid components, each component was evaluated independently. Qualitatively observed SIs were also correlated with tumor consistency.
RESULTS
Statistical analysis revealed significant correlation between tumor consistency and ADC ratio (r = -0.586, p = 0.002), SI ratios on T2-weighted images (r = -0.497, p = 0.010), and observed SIs on T2-weighted images (r = -0.461, p = 0.018). The relative ratio of ADC value correlated with tumor consistency most strongly.
CONCLUSION
The measured ratio of ADC, SI ratio and observed SI grade on T2-weighted images can provide valuable information about the consistency of brain tumor.

Keyword

Consistency; Brain tumor; Diffusion weighted image

MeSH Terms

Brain
Brain Neoplasms
Humans
Retrospective Studies

Figure

• 

  Fig. 1 Metastatic tumor with hard consistency in 44-year-old woman. (a) Axial T2WI shows a homogenous hyperintense (grade 1) mass. (b) Axial DWI shows a hypointense lesion (grade -2) with respect to normal white matter. (c) ADC maps shows a mass with increased diffusion coefficient (grade 1).

• 

  Fig. 2 Metastatic mucoepidermoid carcinoma with gelatinous consistency in 67-year-old man. (a) Axial T2WI shows homogenous hyperintense (grade 3) masses. (b) Axial DWI shows hypointense masses (grade -2) with respect to normal white matter. (c) ADC maps shows masses with increased diffusion coefficient (grade 3).

• 

  Fig. 3 Glioblastoma with friable consistency in 69-year-old man. (a) Axial T2WI shows a homogenous hyperintense (grade 2) mass. (b) Axial DWI shows a hypointense lesion (grade -1) with respect to normal white matter. (c) ADC maps shows a mass with slightly increased diffusion coefficient (grade 1).

• 

  Fig. 4 Glioblastoma with friable consistency in 42-year-old man. (a) Axial T2WI shows a homogenous hyperintense (grade 1) mass. (b) Axial DWI shows a hyperintense lesion (grade 2) with respect to normal white matter. (c) ADC maps shows a mass with slightly decreased diffusion coefficient (grade -2).

• 

  Fig. 5 Box plot shows relative SI ratios on ADC in tumor consistency groups. Relative SI ratios on ADC are significantly correlated with intra-axial brain tumor consistency. *, §, ¶ = significant different from cystic consistency group *p = 0.02 , §p = 0.014, ¶p = 0.032

• 

  Fig. 6 Box plot shows relative SI ratios on T2WI in tumor consistency groups. Relative SI ratios on T2WI are significantly correlated with intra-axial brain tumor consistency. *, §, ¶ = significant different from cystic consistency group *p = 0.033, §p = 0.044, ¶p = 0.045

• 

  Fig. 7 Box plot shows qualitative SI grade on T2WI in tumor consistency groups. SI grade on T2WI are significantly correlated with intra-axial brain tumor consistency.

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