Diffusion Tensor Magnetic Resonance Imaging in Ring-Enhancing Cerebral Lesions |
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Authors: | Lei Shi Hui Zhang Yan-Feng Meng Jin-Sheng Su Guo-Liang Shao |
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Institution: | (1) Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, 310022, China;(2) Department of Radiology, No. 1 Hospital, Shanxi Medical University, Taiyuan, 030001, China;(3) Image-Guided Bio-Molecular Interventions Research, Department of Radiology, University of Washington School of Medicine, Seattle, USA;(4) Department of Radiology, Central Hospital of Taiyuan, Taiyuan, 030001, China |
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Abstract: | The objective of this study is to determine differential diagnostic value of diffusion tensor imaging (DTI) in high-grade
brain astrocytomas, brain solitary metastases and brain abscesses. 53 patients with cerebral solitary lesions which showed
ring enhancement on contrast-enhanced T
1-weighted images were enrolled in this study. Brain tissues were examined pathologically from 49 patients to confirm the cerebral
occupational diseases. Four patients have been diagnosed with primary cancer plus brain solitary metastasis. DTI measurements
were obtained from regions of interest placed on central cavity, white matter of the immediate peritumoral region (IPR) and
cerebral white matter of the normal side. The cavity of high-grade astrocytoma and brain metastases displayed hypointense
signals; most of the brain abscess cavities displayed high signal intensity except for one case with uneven signal intensity.
Mean diffusivity (MD) and fractional anisotropy (FA) values could be used for differentiation between tumor and abscess in
brain. The brain abscess cavities showed restricted diffusion and anisotropy MD = (0.604 ± 0.13) × 10−3 mm2/s, FA = 0.185 ± 0.03], whereas the central portion of high-grade astrocytoma MD = (2.76 ± 0.26) × 10−3 mm2/s, FA = 0.069 ± 0.02] and solitary brain metastases MD = (2.82 ± 0.29) × 10−3 mm2/s, FA = 0.064 ± 0.02] showed unrestricted diffusion and isotropy. Brain abscess could be differentiated by MD and FA values
in their cavities from brain tumors (P < 0.01). The IPRs were all depicted as hyperintense or isointense signals on diffusion-weighted imaging. The difference between
FA values in the IPR of high-grade brain astrocytomas and other groups was statistically significant (P < 0.01). In conclusion, our results suggested the potential role of the cavity MD and FA values in the differential diagnoses
of brain tumors and brain abscesses; meanwhile, high-grade astrocytomas could be distinguished from solitary metastases and
abscesses by evaluating their corresponding FA values in the IPR on brain magnetic resonance imaging (MRI). Combined with
conventional MRI, DTI may help radiologists to facilitate the differential diagnosis of ring-enhancing cerebral lesions in
clinical practice. |
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