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首页> 外文期刊>American Journal of Neuroradiology >Neuroimaging in Pediatric Brain Tumors: Gd-DTPA-enhanced, Hemodynamic, and Diffusion MR Imaging Compared with MR Spectroscopic Imaging
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Neuroimaging in Pediatric Brain Tumors: Gd-DTPA-enhanced, Hemodynamic, and Diffusion MR Imaging Compared with MR Spectroscopic Imaging

机译：小儿脑肿瘤中的神经影像：Gd-DTPA增强，血流动力学和扩散MR成像与MR光谱成像相比

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BACKGROUND AND PURPOSE: Gadolinium-enhanced MR images assist in defining tumor borders; however, the relation between tumor cell extent and contrast-enhanced regions is unclear. Our aim was to improve conventional neuroimaging of pediatric brain tumors with hemodynamic, diffusion, and spectroscopic MR imaging. METHODS: We performed conventional MR and MR spectroscopic imaging in 31 children with neuroglial brain tumors. Hemodynamic MR imaging was performed in 16 patients with a first-pass intravenous bolus of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA); apparent diffusion coefficients (ADCs) were measured in 12 patients. To account for multiple measurements in a patient, we used a nested analysis of variance. RESULTS: At MR spectroscopy, choline (Cho)-containing compounds (indicating tumor) and lipid levels (indicating necrosis) did not correlate with percent Gd-DTPA enhancement on MR images. Percent enhancement was positively correlated with relative cerebral blood volumes (rCBVs) (P = .05) and negatively correlated with ADCs (P < .001). Stepwise multiple linear regression revealed that rCBV (P = .008), ADC (P = .022), and lipid (P < .001) levels were significant independent predictors of percent enhancement. Tumor spectral patterns were detected in tumor regions and outside enhancing tumor beds in patients with clinical progression; these were confirmed at neuropathologic analysis. CONCLUSION: MR spectroscopic imaging improves the assessment of pediatric brain tumors by adding biochemical information regarding tumor involvement and by depicting residual or recurrent tumor outside the Gd-DTPA–enhanced tumor bed. rCBV and ADC mapping complemented MR spectroscopic imaging. We recommend the use of MR spectroscopic imaging in addition to conventional MR imaging in assessing pediatric brain tumors.
机译：背景与目的：Ga增强的MR图像有助于 定义肿瘤边界。然而，肿瘤 细胞范围与增强对比区域之间的关系尚不清楚。我们的目标 是通过血液动力学，扩散和光谱MR成像来改善小儿脑部常规神经影像学。 方法：我们进行了常规MR和MR光谱成像 在31例神经胶质脑肿瘤患儿中。血液动力学MR 影像学检查在16例患者首次通过静脉推注bol二乙烯三胺五乙酸（Gd-DTPA）;表观扩散系数（在12位患者中测量了ADCs。 为说明患者的多次测量结果，我们使用了 嵌套方差分析。 结果：在MR光谱学，含胆碱（Cho）的化合物 （表明肿瘤）和脂质水平（表明坏死）与MR图像上的Gd-DTPA增强百分比不相关。 增强百分比与相对 大脑血容量（rCBVs）正相关（P = .05），与 与ADC负相关（P <.001）。逐步多元线性回归 表明rCBV（P = .008），ADC（P = .022）和脂质（P <.001）水平是以下因素的重要独立预测因子 百分比增强。在 临床进展的患者中，在 肿瘤区域和外部增强肿瘤床中检测到了肿瘤光谱模式；结论：MR光谱成像通过添加生化信息 。 >通过在Gd-DTPA增强的肿瘤床外描绘残留或复发性 肿瘤来研究肿瘤的受累情况。 rCBV和 ADC映射补充了MR光谱成像。除了常规的 MR成像，我们建议 使用MR光谱成像来评估小儿脑肿瘤。

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  • 来源
    《American Journal of Neuroradiology》 |2002年第2期|322-333|共12页
  • 作者

    A. Aria Tzika; Maria K. Zarifi; Liliana Goumnerova; Loukas G. Astrakas; David Zurakowski; Tina Young-Poussaint; Douglas C. Anthony; R. Michael Scott; Peter McL. Black;

  • 作者单位

    Department of Radiology, Children’s Hospital, Harvard Medical School, Boston, MA;

    Department of Radiology, Children’s Hospital, Harvard Medical School, Boston, MA;

    Department of Neurosurgery, Children’s Hospital, Harvard Medical School, Boston, MA;

    Department of Radiology, Children’s Hospital, Harvard Medical School, Boston, MA;

    Department of Biostatistics, Children’s Hospital, Harvard Medical School, Boston, MA;

    Department of Radiology, Children’s Hospital, Harvard Medical School, Boston, MA;

    Department of Pathology, Children’s Hospital, Harvard Medical School, Boston, MA;

    Department of Neurosurgery, Children’s Hospital, Harvard Medical School, Boston, MA;

    Department of Neurosurgery, Children’s Hospital, Harvard Medical School, Boston, MA;

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