Dynamic Contrast Enhanced MRI in Glioma Diagnosis

Abstract

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