4.5 Article

Brain Glioma Localization Diagnosis Based on Magnetic Resonance Imaging

Journal

WORLD NEUROSURGERY
Volume 149, Issue -, Pages 325-332

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.wneu.2020.09.113

Keywords

Brain metastasis; DCE-MRI; Glioma; Meningioma; Primary central nervous system glioma

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This study utilized DCE-MRI technology and its perfusion parameters to diagnose and differentially diagnose brain tumors, showing that DCE-MRI can accurately distinguish between HGG and LGG, with t-Ktrans value demonstrating higher specificity and sensitivity.
BACKGROUND: We used dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) technology and its perfusion parameters to diagnose central glioma high-grade glioma (HGG), primary central nervous system glioma low-grade glioma (LGG), brain metastases, and meningioma and make differential diagnoses. METHODS: Forty-one cases of brain tumors (8 cases of LGG, 17 cases of HGG, 5 cases of primary central nervous system lymphoma = PCNSL], 6 cases of brain metastases, and 5 cases of meningiomas) were subjected to routine and DCE-MRI scans. The DCE-MRI quantitative parameters of the tumor parenchymal area and peripheral enema area of each tumor were measured and recorded as t-Ktrans value, t-Ve value, t-Vp value, t-Kep value and p-Ktrans value, p-Ve value, p-Vp value, and p-Kep value. RESULTS: Compared with other tumor types, LGG showed lower t-Ktrans value (P < 0.01, sensitivity = 89%, specificity = 99%) and low t-Ve value (P < 0.01, sensitivity = 94%, specificity = 100%); PCNSL showed a high tVe value (P < 0.01, sensitivity = 100%, specificity = 88%), but other perfusion parameters overlap more obviously with other tumors. Compared with LGG, the difference between t-Ktrans value, t-Ve value, and t-Kep value is statistically significant. Among them, t-Ktrans value distinguishes the highest sensitivity and specificity (when t-Ktrans value = when 0.154 is the cutoff value, the area under the curve is 1.000, P = 0.000, specificity = 100%, sensitivity = 94.1%); compared with PCNSL, the difference of t-Ve value between HGG and PCNSL is statistically significant, t-Ve of PCNSL. The value is slightly higher, and its specificity and sensitivity are not high. CONCLUSIONS: DCE-MRI can distinguish HGG and LGG more accurately, of which t-Ktrans value has higher specificity and sensitivity, although the difference of t-Ve value between PCNSL and HGG is statistically significant but the sensitivity and specificity are not high; the p-Ktrans value and p-Kep value of metastatic tumors are lower than HGG and have higher specificity, but meningiomas and HGG and PCNSL, meningiomas and metastases are not accurate identification.

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