Triple-dose Contrast/magnetization Transfer Suppressed Imaging of ‘non-enhancing’ Brain Gliomas
Tóm tắt
PURPOSE: Triple-dose (TD) gadolinium contrast administration and magnetization transfer suppression (MTS) in brain magnetic resonance imaging (MRI) have proven to be useful for demonstrating additional enhancing lesions in some diseases. The purpose of this study was to determine if there is a subset of brain tumors that demonstrate contrast enhancement with TD and MTS that do not enhance with standard imaging and standard contrast dose. MATERIALS AND METHODS: Fifteen patients with either newly diagnosed primary brain tumor or brain tumor that had been followed for more than 2 years were enrolled. T1-weighted MTS images without IV contrast, with 0.1 mmol/kg without MTS (single-dose (SD) images), and with additional 0.2 mmol/kg gadolinium and MTS (‘TD/MTS’) were obtained. RESULTS: None of the patients had enhancement on SD images. Six patients had areas of enhancement on TD/MTS images (‘exact’ chi-squared p=0.017). CONCLUSION: A statistically significant increased rate of contrast enhancement was found on TD/MTS images in patients whose tumors did not enhance at single dose without MTS. It is possible that small areas of enhancement seen only with TD/MTS might represent areas of higher-grade tumor.
Tài liệu tham khảo
Sze G, Johnson C, Kawamura Y, Goldberg S, Lange R, Friedland R, Wolf R: Comparison of single-and triple-dose contrast material in the MR screening of brain metastases. AJNR Am J Neuroradiol 19: 821–828, 1998
Kuhn M, Hammer G, Swenson L, Youssef H, Gleason T: MRI evaluation of 'solitary' brain metastases with tripledose gadoteridol: comparison with contrast-enhanced CT and conventional-dose gadopentetate dimeglumine MRI studies in the same patients. Comput Med Imaging Graph 18: 391–399, 1994
Filippi M, Yousry T, Campi A, Kandziora C, Colombo B, Voltz R, Martinelli V et al.: Comparison of triple dose versus standard dose gadolinium-DTPA for detection of MRI enhancing lesions in patients with MS. Neurology 46: 379–384, 1996
Rovaris M, Capra R, Martinelli V, Gasperini C, Prandini F, Pozzilli C, Comi G, Filippi M: Cumulative effect of a weekly low dose of interferon beta 1a on standard and triple dose contrast-enhanced MRI from multiple sclerosis patients. J Neurol Sci 171: 130–134, 1999
Filippi M, Campi A, Martinelli V, Colombo B, Yousry T, Canal N, Scotti G, Comi G: Comparison of triple dose versus standard dose gadolinium-DTPA for detection of MRI enhancing lesions in patients with primary progressive multiple sclerosis. J Neurol Neurosurg Psychiatry 59: 540–544, 1995
Knauth M, Forsting M, Hartmann M, Heiland S, Balzer T, Sartor K: MR enhancement of brain lesions: increased contrast dose compared with magnetization transfer. AJNR Am J Neuroradiol 17: 1853–1859, 1996
Yuh W, Tali E, Nguyen H, Simonson T, Mayr N, Fisher D: The effect of contrast dose, imaging time, and lesion size in the MR detection of intracerebral metastasis. AJNR Am J Neuroradiol 16: 373–380, 1995
Roessler K, Czech T, Dietrich W, Ungersboeck K, Nasel C, Hainfellner J, Koos W: Frameless stereotactic-directed tissue sampling during surgery of suspected low-grade gliomas to avoid histological undergrading. Minim Invasive Neurosurg 41: 183–186, 1998
Mehta RC, Pike GB, Enzmann DR: Improved detection of enhancing and nonenhancing lesions of multiple sclerosis with magnetization transfer. AJNR Am J Neuroradiol 16: 1771–1778, 1995
Donahue B, Scott C, Nelson J, Rotman M, Murray K, Nelson D, Banker F, Earle J, Fischbach J, Asbell S, Gaspar L, Markoe A, Curran W: Influence of an oligodendroglial component on the survival of patients with anaplastic astrocytomas: a report Radiation Therapy Oncology Group 83–02. Int J Radiat Oncol Biol Phys 38: 911–914, 1997