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American Journal of Neuroradiology

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Abstract

Dynamic contrast enhancement of intracranial tumors with snapshot-FLASH MR imaging.

T Nägele, D Petersen, U Klose, W Grodd, H Opitz, E Gut, J Martos and K Voigt
American Journal of Neuroradiology January 1993, 14 (1) 89-98;
T Nägele
Abteilung für Neuroradiologie, Universität Tübingen, Germany.
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D Petersen
Abteilung für Neuroradiologie, Universität Tübingen, Germany.
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U Klose
Abteilung für Neuroradiologie, Universität Tübingen, Germany.
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W Grodd
Abteilung für Neuroradiologie, Universität Tübingen, Germany.
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H Opitz
Abteilung für Neuroradiologie, Universität Tübingen, Germany.
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E Gut
Abteilung für Neuroradiologie, Universität Tübingen, Germany.
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J Martos
Abteilung für Neuroradiologie, Universität Tübingen, Germany.
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K Voigt
Abteilung für Neuroradiologie, Universität Tübingen, Germany.
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Abstract

PURPOSE To investigate whether exact evaluation of the dynamic contrast enhancement pattern within intracranial tumors can help to classify tumor histology and vascularity.

METHOD Forty-nine patients suffering from different intra- and extraaxial intracranial tumors underwent MR-examination in a 1.5-T superconductive whole body system. After rapid injection of Gd-DTPA, 48 images were acquired during the first 1.5 to 2 minutes of contrast enhancement within the tumors. A fast snapshot-FLASH imaging technique allowed measurement times of 1 second per image. Appearance of Gd-DTPA in a venous sinus served as a temporal reference point. Transformation of 48 discrete measurement points (mean signal values of the enhancing tumor region) into a continuous curve, using a cubic spline approximation, allowed calculation of the time of maximum signal increase (Tm1) and the following time of half maximum increase (Tm2). These time parameters were compared to histopathologic findings, especially the degree of tumor vascularization.

RESULTS Significantly different dynamic patterns of the early enhancement period were found for the different tumors. All eight neurinomas, typically less vascularized than most meningiomas, showed a characteristically prolonged contrast enhancement with a long Tm2. Histopathologic findings concerning the degree of vascularization showed two subtypes in meningiomas (n = 17) as well as in pituitary macroadenomas (n = 7). This was confirmed by dynamic evaluation in all cases, in the sense that short Tm1 and Tm2 were found in cases with higher degrees of vascularization. Negatives values of Tm1 were measured in two glomus jugulare tumors, reflecting the arterialization of these vascular tumors. In neuroepithelial tumors (n = 15), the glioblastomas (n = 7) showed very short Tm1 compared to the lower grade gliomas (n = 8). This is explained by histologic findings of pathologic vessels with arteriovenous shunts.

CONCLUSION The evaluated dynamic time parameters can be used to narrow differential diagnostic possibilities and to infer the degree of vascularization of intracranial tumors.

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American Journal of Neuroradiology
Vol. 14, Issue 1
1 Jan 1993
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Dynamic contrast enhancement of intracranial tumors with snapshot-FLASH MR imaging.
T Nägele, D Petersen, U Klose, W Grodd, H Opitz, E Gut, J Martos, K Voigt
American Journal of Neuroradiology Jan 1993, 14 (1) 89-98;

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Dynamic contrast enhancement of intracranial tumors with snapshot-FLASH MR imaging.
T Nägele, D Petersen, U Klose, W Grodd, H Opitz, E Gut, J Martos, K Voigt
American Journal of Neuroradiology Jan 1993, 14 (1) 89-98;
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