Grading of Glioma Tumors by Analysis of Minimum Apparent Diffusion Coefficient and Maximum Relative Cerebral Blood Volume

摘要

Gliomas are the most common primary neoplasms of theudcentral nervous system. Relative cerebral blood volume (rCBV) couldudestimate high-grade Gliomas computed with dynamic susceptibility contrastudMR imaging which it is artificially lowered by contrast extravasation throughuda disrupted blood-brain barrier.udObjectives: Our intent was to clarify the usefulness of diffusion-weightedudmagnetic resonance imaging (DWI) and perfusion weighted magneticudresonance imaging (PWI) in the grading of Gliomas.udMaterials and Methods: Both PWI and DWI with a three-tesla scannerudinvestigated nineteen consecutive patients with Gliomas. The means of rCBVudand ADC values have been compared among the tumor groups with t-test andudROC curve analysis to determine threshold values of Gliomas grading.udResults: Mean maximum rCBV were 2.71±1.41 for low grades (I & II), andud8.14±2.58 for high grades (III & IV) Gliomas (p=0.001). Mean minimumudADC were 1.47±.46 ×103 mm2ud/s for low grades (I & II), and .47±.38×103udmm2ud/s for high grades (III & IV) Gliomas (p=0.001). We can get 0.94×103udmm2ud/s for minimum ADC and 3.85 for maximum rCBV as a difference cutoffudpoint between low and high-grade Gliomas.udConclusion: Combination of both DWI and PWI techniques, withudmeasurement of minimum ADC and maximum rCBV can be used touddistinguish between high grade and low-grade Glioma tumors.