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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 22:1089-1096 (6 2001)
© 2001 American Society of Neuroradiology

ARTICLE

Quantitative MR Evaluation of Intracranial Epidermoid Tumors by Fast Fluid-attenuated Inversion Recovery Imaging and Echo-planar Diffusion-weighted Imaging

Shuda Chen^a, Fusao Ikawa^a, Kaoru Kurisu^a, Katsunori Arita^a, Junko Takaba^a and Yukari Kanou^a

^a From the Departments of Neurosurgery (S.C., K.K., K.A., Y.K.) and Radiology (J.T.), Hiroshima University School of Medicine, Hiroshima, and the Department of Neurosurgery (F.I.), Shimane Prefectural Central Hospital, Shimane, Japan.

BACKGROUND AND PURPOSE: Quantification of MR can provide objective, accurate criteria for evaluation of a given MR sequence. We quantitatively compared conventional MR sequences with fast fluid-attenuated inversion recovery (fast-FLAIR) and echo-planar diffusion-weighted (DW) MR imaging in the examination of intracranial epidermoid tumors.

METHODS: Eight patients with surgically confirmed intracranial epidermoid tumors were examined with T1-weighted MR sequences, fast T2- and proton density–weighted dual-echo sequences, fast-FLAIR sequences, and DW echo-planar sequences. We measured the MR signal intensity and apparent diffusion coefficient (ADC) of epidermoid tumors, normal brain tissue, and CSF and calculated the tumor-to-brain and tumor-to-CSF contrast ratios and contrast-to-noise ratios (CNR). Results were compared among the five MR methods.

RESULTS: On fast-FLAIR imaging, the mean signal intensity of epidermoid tumors was significantly higher than that of CSF but significantly lower than that of the brain; the contrast ratio and CNR of tumor-to-CSF were 4.71 and 9.17, respectively, significantly greater than the values with conventional MR imaging. On echo-planar DW imaging, epidermoid tumors showed a remarkably hyperintense signal relative to those of the brain and CSF; the mean contrast ratio and CNR of tumor-to-CSF were 13.25 and 19.34, respectively, significantly greater than those on fast-FLAIR or conventional MR imaging. The mean ADC of epidermoid tumors was 1.197 x 10^-3 mm²/s, significantly lower than that of CSF but higher than that of brain tissues.

CONCLUSION: Fast-FLAIR imaging is superior to conventional MR imaging in depicting intracranial epidermoid tumors. Echo-planar DW imaging provides the best lesion conspicuity among the five MR methods. The hyperintensity of epidermoid tumors on echo-planar DW imaging is not caused by the diffusion restriction but by the T2 shine-through effect.

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