To analyse the role of MR diffusion-tensor imaging (DTI) and perfusion-weighted imaging (PWI) in characterising tumour boundaries in patients with glioblastoma multiforme. Seventeen patients with surgically treated WHO IV grade gliomas who were candidates for adjuvant chemo-radiotherapy were enrolled. Before (T0) and after radiation treatment (T1), they underwent DTI and PWI, and the apparent diffusion coefficient (ADC), fractional anisotropy (FA) and relative cerebral blood volume (rCBV) in the enhancing tumour, the hyperintense tissue adjacent to the enhancing tumour, and the normal-appearing white matter (NAWM) adjacent to the hyperintense areas were analysed. The enhancing tissue at T1 was retrospectively divided on the basis of whether or not it was also enhancing at T0. The controls were the corresponding contralateral areas, on which we normalized the rCBV values, calculating the rCBV ratio. In NAWM, we did not find any significant differences in FA, ADC or rCBV. In the hyperintense perilesional regions, FA was significantly lower and ADC significantly higher than in the unaffected contralateral tissue; there were no significant differences in the rCBV maps. The values of FA, ADC and rCBV in enhancing neoplastic tissue were all significantly different from those observed in the contralateral tissue. There was no significant difference in rCBV values between the areas enhancing at T0 and those not enhancing at T0 but enhancing at T1, which may indicate the neoplastic transformation of apparently normal brain tissue. DTI metrics identify ultrastructural changes in hyperintense perilesional areas, but these are not specific for neoplastic tissue. rCBV seemed to reflect an ultrastructural alteration that was not visible at T0, but became visible (as neoplastic progression) on conventional MR images at T1. These findings could help identify tissue at risk of tumour infiltration.

译文

:分析MR扩散张量成像(DTI)和灌注加权成像(PWI)在表征多形性胶质母细胞瘤患者肿瘤边界中的作用。纳入了17例经手术治疗的WHO IV级神经胶质瘤患者,这些患者为辅助化学放疗的候选人。在(T0)之前和在放射治疗(T1)之后,他们经历了DTI和PWI,并且在增强肿瘤(毗邻的高强度组织)中出现了表观扩散系数(ADC),分数各向异性(FA)和相对脑血容量(rCBV)。分析肿瘤的增强情况,并分析与高信号区相邻的正常出现的白质(NAWM)。根据T1处的增强组织是否在T0处也进行增强进行回顾性划分。对照是相应的对侧区域,我们在其上标准化了rCBV值,计算了rCBV比率。在NAWM中,我们没有发现FA,ADC或rCBV有任何显着差异。在高强度病灶周围区域,FA明显低于ADC,而ADC明显高于未受影响的对侧组织。 rCBV图没有显着差异。增强肿瘤组织中的FA,ADC和rCBV值均与对侧组织中观察到的值显着不同。在T0增强的区域和在T0不增强但在T1增强的区域之间,rCBV值没有显着差异,这可能表明表面正常的脑组织发生了肿瘤性转化。 DTI指标可确定高强度病灶周围区域的超微结构变化,但这些变化并非专门针对赘生性组织。 rCBV似乎反映了一种超微结构改变,该改变在T0时不可见,但在T1时的常规MR图像上变得可见(随着肿瘤的进展)。这些发现可能有助于确定有肿瘤浸润风险的组织。

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