medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-2017-4-88-96medvis-453Research ArticleГОЛОВА И ШЕЯHEAD AND NECKМагнитно-резонансная томография в режиме динамического контрастирования в дифференциальной диагностике глиальных опухолей головного мозгаDynamic Contrast Enhanced MRI in Glioma DiagnosisНечипайЭ. А.NechipayE. A.nechipay@hotmail.comДолгушинМ. Б.DolgushinM. B.ПронинА. И.ProninA. I.КобяковаЕ. А.KobyakovaE. A.ФадееваЛ. М.FadeevaL. M.ФГБУ “Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина” Минздрава РоссииРоссияN.N. Blokhin National Medical Research Center of OncologyRussian FederationФГАУ “Национальный медицинский исследовательский центр нейрохирургии им. акад. Н.Н. Бурденко” Минздрава РоссииРоссияN.N. Burdenko National Medical Research Center of NeurosurgeryRussian Federation201728082017048896Copyright © Нечипай Э.А., Долгушин М.Б., Пронин А.И., Кобякова Е.А., Фадеева Л.М., 20172017Нечипай Э.А., Долгушин М.Б., Пронин А.И., Кобякова Е.А., Фадеева Л.М.Nechipay E.A., Dolgushin M.B., Pronin A.I., Kobyakova E.A., Fadeeva L.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/453Цель исследования

Цель исследования: изучение возможности применения методики магнитно-резонансного  динамичес кого контрастирования (МР-ДК) в уточняющей диагнос тике глиальных опухолей  головного мозга и дифференциации их между собой по признаку степени  злокачественности. В связи с этим авторами оценена эффективность ряда перфузионных  параметров (Ktrans, Kep, Ve и iAUC) в решении этой задачи.

Материал и методы

Материал и методы. В исследование включены наблюдения 54 пациентов с  установленным наличием глиальных новообразований вещества головного мозга. Глиомы  Grade I–II диагностированы в 13 (24,1%), а глиомы Grade III–IV – в 41 (75,9%) случае.  Морфологическая верификация диагноза по образцам опухолевой ткани, полученной в  результате либо хирургического удаления опухоли, либо путем стереотаксической биопсии,  была достигнута у 31 (57,4%) пациента: глиальные опухоли Grade I–II идентифицированы у  6 (19,4%), а глиомы Grade III–IV – у 25 (80,6%) пациентов.

Результаты

Результаты. По данным МР-ДК с увеличением степени злокачественности глиальной  опухоли отмечается повышение всех исследуемых перфузионных параметров: так, наиболее низкие значения Ktrans, Kep, Ve и iAUC выявлены в глиомах низкой степени  злокачественности (0,026 мин−1, 0,845 мин−1, 0,024 и 1,757 соответственно), наиболее  высокие – в глиомах Grade III–IV (0,052 мин−1, 1,083 мин−1, 0,06 и 2,694 соответственно).  Наиболее информативными показателями (с чувствительностью и специфичностью 90 и  100% соответственно) в дифференциальной диагностике глиом Grade I–II от Grade III–IV являются Ktrans (cut-off = 0,16 мин−1) и Ve (cut-off = 0,13).

Заключение

Заключение. Методику МР-ДК можно применять в целях дифференциальной диагностики  глиальных опухолей разной степени злокачественности.

The aim

The aim: to examine the possibility of using dynamic contrast  enhanced magnetic resonance imaging (DCE MRI) in clarifying the  diagnosis of glial brain tumors and the differentiation between them  on the basis of the malignancy degree. In this regard, the authors  evaluated the effectiveness of perfusion parameters (Ktrans, Kep, Ve and iAUC).

Materials and methods

Materials and methods. The study included examination of 54  patients with an established presence of brain glial tumors. Glioma  Grade I–II diagnosed in 13 (24.1%) and glioma Grade III–IV in 41  (75.9%) cases. Morphological verification of the diagnosis obtained  as a result of either surgical removal of the tumor or stereotactic biopsy was achieved in 31 (57.4%) patients: glial tumors Grade I–II  identified in 6 (19.4%), and glioma Grade III–IV – 25 (80.6%) cases.

 

 

Results

Results. According to DCE increasing of the malignancy degree of  glial tumors is followed by increasing of all perfusion parameters:  thus, the lowest values of Ktrans, Kep, Ve and iAUC were identified  in low grade gliomas (0.026 min−1, 0.845 min−1, 0.024 and 1.757,  respectively), the highest in gliomas Grade III–IV (0.052 min−1  1.083 min−1, 0.06 and 2.694, respectively). The most informative parameters with sensi tivity 90% and specificity 100% in the  differential diagnosis of gliomas Grade I-II and Grade III-IV are  Ktrans (cut-off = 0.16 min−1) and Ve (cut-off = 0.13).

Conclusion

Conclusion. DCE MRI can be used in differential diagnosis of glial brain tumors of different malignancy grade.

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The authors declare that there are no conflicts of interest present.