PDF(Pubmed)
Abstract：
BACKGROUND: We aimed to describe the microvascular features of three types of adult-type diffuse glioma by comparing dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging (MRI) with intraoperative high-frame-rate ultrafast Doppler ultrasound.
METHODS: Case series of seven patients with primary brain tumours underwent both DSC perfusion MRI and intra-operative high-frame-rate ultrafast Doppler ultrasound. From the ultrasound images, three-dimensional vessel segmentation was obtained of the tumour vascular bed. Relative cerebral blood volume (rCBV) maps were generated with leakage correction and normalised to the contralateral normal-appearing white matter. From tumour histograms, median, mean, and maximum rCBV ratios were extracted.
RESULTS: Low-grade gliomas (LGGs) showed lower perfusion than high-grade gliomas (HGGs), as expected. Within the LGG subgroup, oligodendroglioma showed higher perfusion than astrocytoma. In HGG, the median rCBV ratio for glioblastoma was 3.1 while astrocytoma grade 4 showed low perfusion with a median rCBV of 1.2. On the high-frame-rate ultrafast Doppler ultrasound images, all tumours showed a range of rich and organised vascular networks with visually apparent abnormal vessels, even in LGG.
CONCLUSIONS: This unique case series revealed in vivo insights about the microvascular architecture in both LGGs and HGGs. Ultrafast Doppler ultrasound revealed rich vascularisation, also in tumours with low perfusion at DSC MRI. These findings warrant further investigations using advanced MRI postprocessing, in particular for characterising adult-type diffuse glioma.
CONCLUSIONS: Our findings challenge the current assumption behind the estimation of relative cerebral blood volume that the distribution of blood vessels in a voxel is random.
CONCLUSIONS: • Ultrafast Doppler ultrasound revealed rich vascularity irrespective of perfusion dynamic susceptibility contrast MRI state. • Rich and organised vascularisation was also observed even in low-grade glioma. • These findings challenge the assumptions for cerebral blood volume estimation with MRI.
METHODS: Case series of seven patients with primary brain tumours underwent both DSC perfusion MRI and intra-operative high-frame-rate ultrafast Doppler ultrasound. From the ultrasound images, three-dimensional vessel segmentation was obtained of the tumour vascular bed. Relative cerebral blood volume (rCBV) maps were generated with leakage correction and normalised to the contralateral normal-appearing white matter. From tumour histograms, median, mean, and maximum rCBV ratios were extracted.
RESULTS: Low-grade gliomas (LGGs) showed lower perfusion than high-grade gliomas (HGGs), as expected. Within the LGG subgroup, oligodendroglioma showed higher perfusion than astrocytoma. In HGG, the median rCBV ratio for glioblastoma was 3.1 while astrocytoma grade 4 showed low perfusion with a median rCBV of 1.2. On the high-frame-rate ultrafast Doppler ultrasound images, all tumours showed a range of rich and organised vascular networks with visually apparent abnormal vessels, even in LGG.
CONCLUSIONS: This unique case series revealed in vivo insights about the microvascular architecture in both LGGs and HGGs. Ultrafast Doppler ultrasound revealed rich vascularisation, also in tumours with low perfusion at DSC MRI. These findings warrant further investigations using advanced MRI postprocessing, in particular for characterising adult-type diffuse glioma.
CONCLUSIONS: Our findings challenge the current assumption behind the estimation of relative cerebral blood volume that the distribution of blood vessels in a voxel is random.
CONCLUSIONS: • Ultrafast Doppler ultrasound revealed rich vascularity irrespective of perfusion dynamic susceptibility contrast MRI state. • Rich and organised vascularisation was also observed even in low-grade glioma. • These findings challenge the assumptions for cerebral blood volume estimation with MRI.
摘要：
背景：我们旨在通过比较动态磁化率对比（DSC）灌注磁共振成像（MRI）与术中高帧率超快多普勒超声来描述三种成人型弥漫性神经胶质瘤的微血管特征。
方法：病例系列7例原发性脑肿瘤患者同时接受DSC灌注MRI和术中高帧率超快多普勒超声检查。从超声图像来看，获得了肿瘤血管床的三维血管分割。通过泄漏校正生成相对脑血容量（rCBV）图，并将其归一化为对侧正常出现的白质。从肿瘤直方图，中位数，意思是，提取了最大rCBV比率。
结果：低级别胶质瘤（LGGs）的灌注低于高级别胶质瘤（HGG），如预期。在LGG子组内，少突胶质细胞瘤的灌注高于星形细胞瘤。在HGG,胶质母细胞瘤的rCBV中位数为3.1,而4级星形细胞瘤显示低灌注,rCBV中位数为1.2.在高帧率超快多普勒超声图像上,所有肿瘤都显示出一系列丰富和有组织的血管网络，视觉上明显的异常血管，甚至在LGG。
结论：这个独特的病例系列揭示了关于LGG和HGG的微血管结构的体内见解。超快多普勒超声显示血管丰富，在DSCMRI低灌注的肿瘤中也是如此。这些发现需要使用先进的MRI后处理进行进一步调查，特别是用于描述成人型弥漫性神经胶质瘤。
结论：我们的发现挑战了目前估计相对脑血容量的假设，即血管在体素中的分布是随机的。
结论：•超快多普勒超声显示丰富的血管，与灌注动态敏感性对比MRI状态无关。•甚至在低度神经胶质瘤中也观察到丰富和有组织的血管化。•这些发现挑战了用MRI估计脑血容量的假设。
方法：病例系列7例原发性脑肿瘤患者同时接受DSC灌注MRI和术中高帧率超快多普勒超声检查。从超声图像来看，获得了肿瘤血管床的三维血管分割。通过泄漏校正生成相对脑血容量（rCBV）图，并将其归一化为对侧正常出现的白质。从肿瘤直方图，中位数，意思是，提取了最大rCBV比率。
结果：低级别胶质瘤（LGGs）的灌注低于高级别胶质瘤（HGG），如预期。在LGG子组内，少突胶质细胞瘤的灌注高于星形细胞瘤。在HGG,胶质母细胞瘤的rCBV中位数为3.1,而4级星形细胞瘤显示低灌注,rCBV中位数为1.2.在高帧率超快多普勒超声图像上,所有肿瘤都显示出一系列丰富和有组织的血管网络，视觉上明显的异常血管，甚至在LGG。
结论：这个独特的病例系列揭示了关于LGG和HGG的微血管结构的体内见解。超快多普勒超声显示血管丰富，在DSCMRI低灌注的肿瘤中也是如此。这些发现需要使用先进的MRI后处理进行进一步调查，特别是用于描述成人型弥漫性神经胶质瘤。
结论：我们的发现挑战了目前估计相对脑血容量的假设，即血管在体素中的分布是随机的。
结论：•超快多普勒超声显示丰富的血管，与灌注动态敏感性对比MRI状态无关。•甚至在低度神经胶质瘤中也观察到丰富和有组织的血管化。•这些发现挑战了用MRI估计脑血容量的假设。
