Additional Diagnostic Value of Unenhanced Computed Tomography plus Diffusion-Weighted Imaging Combined with Routine Magnetic Resonance Imaging Findings of Early-Stage Gliblastoma.

Hexiang Wang,Xuejun Liu,Yingchao Liu,Yong Zhang,Weiwei Fu,Feng Hou,Jizheng Lin,Zhenyou Liu

doi:10.1155/2020/1672736

Abstract

Purpose This study was performed to determine whether diffusion-weighted imaging (DWI) plus unenhanced computed tomography (CT) of the brain increases the diagnostic value of routine magnetic resonance (MR) imaging findings of early-stage glioblastoma. Methods Postcontrast MR images of eight unenhanced lesions that had been pathologically diagnosed as glioblastoma were retrospectively examined. The location, margin, signal intensity, and attenuation on MR imaging and CT were assessed. Results On MR imaging, all lesions were ill-defined, small, and isointense to hypointense on T1-weighted images and hyperintense on T2-weighted images. Four patients had perilesional edema. In seven patients, DWI showed an inhomogeneous hyperintense lesion (n = 1) or isointense lesion with a hyperintense region (n = 1) or isointense lesion with a hyperintense region (n = 1) or isointense lesion with a hyperintense region (n = 1) or isointense lesion with a hyperintense region (n = 1) or isointense lesion with a hyperintense region (n = 1) or isointense lesion with a hyperintense region (n = 1) or isointense lesion with a hyperintense region (n = 1) or isointense lesion with a hyperintense region (n = 1) or isointense lesion with a hyperintense region (Conclusions MR imaging was the most sensitive imaging method for depicting early-stage glioblastoma. The CT finding of a hyperattenuated or isoattenuated region combined with the DWI finding of the same region containing an inhomogeneous hyperintense lesion or isointense lesion with a hyperintense region may be a specific diagnostic sign for early-stage glioblastoma. DWI plus unenhanced CT added diagnostic value to the routine MR imaging findings of early-stage glioblastoma.

Highlights

Glioblastoma is the most common primary intracranial neoplasm in adults, accounting for about 15% to 20% of all intracranial tumors [1]
A subgroup of glioblastoma is found at an earlier stage before central necrosis and lesion enhancement occur [3], and about 4% of glioblastoma masses display no enhancement at the first appearance. ese lesions can be misdiagnosed as nonneoplastic cerebral lesions such as infarction, encephalitis, or degenerative or demyelinating disease [2, 4,5,6,7]
BioMed Research International outcome [7]. e correct diagnosis of early-stage glioblastoma is important; when a mass manifests as a nonneoplastic cerebral lesion, the correct diagnosis is usually not made before progression to typical glioblastoma. us, challenges are associated with the use of routine magnetic resonance (MR) imaging for diagnosis of early glioblastoma

Summary

Introduction

Glioblastoma is the most common primary intracranial neoplasm in adults, accounting for about 15% to 20% of all intracranial tumors [1]. Ese lesions can be misdiagnosed as nonneoplastic cerebral lesions such as infarction, encephalitis, or degenerative or demyelinating disease [2, 4,5,6,7]. E correct diagnosis of early-stage glioblastoma is important; when a mass manifests as a nonneoplastic cerebral lesion, the correct diagnosis is usually not made before progression to typical glioblastoma. Several studies of nonneoplastic cerebral lesions such as infarction, encephalitis, and demyelinating or degenerative diseases have shown that unenhanced computed tomography (CT) reveals either mass hypoattenuation or no positive signs [8,9,10,11,12]. Erefore, the purpose of our study was to determine whether unenhanced CT plus DWI of the brain has added value in the diagnosis of early-stage glioblastoma Past studies have shown that diffusionweighted imaging (DWI) is useful for diagnosis of malignant glioma [13]. erefore, the purpose of our study was to determine whether unenhanced CT plus DWI of the brain has added value in the diagnosis of early-stage glioblastoma

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Discussion

Conclusion