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KMID : 0942820090080010016
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Journal of Korean Brain Tumor Society
2009 Volume.8 No. 1 p.16 ~ p.23
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Usefulness and limitation of Perfusion Weighted Magnetic Resonance Imaging in Patients with Brain Tumors
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Jang Won-Seok
Kang Jeong-Han
Cho Jin-Mo
Kim Jinn-A
Kim Eung-Yeop
Ahn Jung-Yong
Kim Dong-Seok
Chang Jong-Hee
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Abstract
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Introduction Accurate diagnosis and grading of brain tumors are critical to determine the specific treatment planning and prognosis of each tumor type. Evaluation of tumor status during treatment to assess therapeutic response and treatmentrelated complications is also important. Recent developments in the field of magnetic resonance imaging(MRI) have been adopted with varying success in the management of brain tumors. We studied the usefulness and limitation of perfusion MRI, one of new MRI techniques, in patients with a brain tumor.
Materials and Methods:We analyzed 100 perfusion MR images in 72 patients who treated between December 2005 to August 2006. The type of lesions was glioma in 62 patients, lymphoma in 11, metastasis in 6, other tumor in 7, and nontumorous lesion in 14. The perfusion MR images were obtained by 3.0T MRI using dynamic contrast enhanced method. We calculated relative cerebral blood volume(rCBV) with dedicated software program.
Results: The mean rCBV of high grade gliomas(WHO grade III-IV) was significantly higher than that of astrocytic low grade gliomas(WHO grade II). Additionally, rCBV of glioma and tumor grading showed positive linear correlation. However, the value of rCBV is not correlated with the tumor grade in glioma with oligodendroglioma component. While there was no statistically significant difference of rCBV between low grade gliomas, and lymphomas or metastatic brain tumors, the rCBV of high grade gliomas was higher than that of lymphomas or metastatic brain tumors. The perfusion MRI was also helpful for distinguishing recurrence of high grade gliomas from radiation necrosis, and the rCBV was higher in recurrent cases.
Conclusion: Even though perfusion MRI has several limitations such as susceptibility artifact, low resolution, the possibility of errors during interpretation, no absolute diagnostic values, and less effectiveness in hypervascular benign tumors or oligodendroglial tumors, this new MRI technique could be a useful method for preoperative diagnosis of brain mass lesion and assessing the results of treatment.
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KEYWORD
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Brain neoplasm, Cerebral blood volume, Glioma, Magnetic resonance imaging, Perfusion imaging
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