Hemodynamic characterization of brain tumors with dual dynamic contrast enhanced magnetic resonance imagine

Morphological information by conventional preoperative magnetic resonance imaging (MRI) is very useful in determing treatment strategies for brain tumors. However, MRI has limitations in the histological differentiation of tumors. The purpose of this study is to investigate characteristics of permeability and vascularity of brain tumors using MRI and to clarify the correlation between the pathology and hemodynamics of tumors. Preoperative Dual Dynamic Contrast Enhanced MR imaging (DUCE), which simultaneously provided dynamic T1 and susceptibility contrast enhanced images, was performed on 77 patients (80 lesions) with brain tumors (meningioma, neuroma, pituitary adenoma, glioblastoma and metastasis). Histological diagnosis was confirmed by surgical specimens. We defined two permeability indexes (Sw: the time to peak of the T1 dynamic curve in the first pass of contrast material, Eg: the gradient of the T1 dynamic curve after the first pass of contrast material) and one vascularity index from a susceptibility dynamic curve (the ratio of relative tumor blood volume and normal white matter blood volume: ∫ΔR 2*dt T/W). These indexes were compared statistically among all tumors. The correlation between each hemodynamic index was analyzed. Both permeability indexes (Sw, Eg) of neuroma were significantly higher than the values for meningioma and pituitary adenoma. The vascularity index (∫ΔR 2*dt T/W) of neuroma was significantly lower than that for meningioma. There was a significantly negative correlation between both permeability indexes and the vascularity index in meningioma. Neuroma could be distinguished from meningioma and pituitary adenoma based on our hemodynamic indexes. (author)