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AJNR - American Journal of Neuroradiology

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MR Cerebral Blood Volume Maps Correlated with Vascular Endothelial Growth Factor Expression and Tumor Grade in Nonenhancing Gliomas

Antonio C. M. Maia, Jr^a,b, Suzana M. F. Malheiros^b, Antonio J. da Rocha^a, Carlos J. da Silva^a, Alberto A. Gabbai^b, Fernando A. P. Ferraz^c and João N. Stávale^d

^a Centro de Medicina Diagnóstica Fleury, Universidade Federal de São Paulo, Brazil
^b Department of Neurology, Universidade Federal de São Paulo, Brazil
^c Department of Neurosurgery, Universidade Federal de São Paulo, Brazil
^d Department of Pathology, Universidade Federal de São Paulo, Brazil

View larger version (61K): [in a new window]   FIG 1. Anaplastic astrocytoma. Axial enhanced T1–weighted image demonstrates a right frontal, nonenhancing lesion (A). rCBV map shows a markedly elevated rCBV of 3.6, which is consistent with biopsy-proved anaplastic astrocytoma (B). Immunohistochemical staining (400x) with monoclonal antibody against VEGF reveals strong cellular and endothelial positivity (C).

View larger version (57K): [in a new window]   FIG 2. Diffuse astrocytoma. Axial enhanced T2-weighted image shows a left frontal nonenhancing lesion (A). rCBV map shows an obviously reduced rCBV of 0.72, which is consistent with biopsy-proved diffuse astrocytoma (WHO grade II). Immunohistochemical staining (400x) with the monoclonal antibody against VEGF is negative (C).

View larger version (58K): [in a new window]   FIG 3. Diffuse astrocytoma. Axial enhanced T1-weighted image shows a left frontal nonenhancing lesion (A). rCBV map shows an elevated rCBV of 1.9 (B). Histologic section (400x) reveals a diffuse astrocytoma (WHO grade II), but VEGF staining shows strong cellular and endothelial positivity (C).

View larger version (60K): [in a new window]   FIG 4. Anaplastic astrocytoma. Coronal enhanced T1-weighted image shows a heterogeneous left frontal lesion (A). rCBV map demonstrates a focal area with a high rCBV of 3.11. Histologic section (400X) of this focus is consistent with biopsy-proved anaplastic astrocytoma, and VEGF staining shows strong cellular and endothelial positivity (C).