Dynamic Contrast-Enhanced Magnetic-Resonance Angiography of Brain Vessels and Perfusion Imaging of Recurrent Brain Tumor

Aim. To evaluate the possibility of differential diagnosis of progression and stabilization of brain tumor process by methods of dynamic contrast-enhanced magnetic-resonance angiography (DCE-MRA) and perfusion MRI in patients after surgical treatment. Materials and methods. The study included 13 patients who were imaged with suspected recurrent tumor disease after surgery. Pathological diagnosis: anaplastic astrocytoma (G3) - 6, astrocytoma (G2) - 4, anaplastic meningeoma - 1, meningioma - 1, cyst - 1. DCE-MRA was performed in 3DFFE imaging technique and in result we got a 3 phase: arterial, venous and equilibrium with slice thickness 1.2 mm. Tumor image and hemodynamics by DCE- MRA imaging and perfusion maps using a 3-point scale were assessed. In addition, it was used three-point scale to determine the contribution PWI and DCE-MRA in addition to the diagnosis of the main results of the contrast study. To describe the changes in the centers of lesions between the images which were obtained after the first and second administration of contrast agent we used a 4-point scale. Results. By comparing evaluation of hemodynamics there were detected significant differences in arterial and venous phase DCE-MRA (p < 0.016), and significant differences between mixed and venous phases were not detected (p > 0.06). Between the ranks of the perfusion maps (rCBV, rCBF and rMTT) there were not found any significant differences, and no differences between the ranks of venous phases DCE-MRA and PWI (p > 0.7). Evaluation of ranks contribution DCE-MRA and pWi for the decision on a definitive diagnosis showed no significant difference between them (p > 0.7). By comparative analysis of DCE-MRA contributions to the final diagnosis on the results of the study in contrasting with double dose there were revealed significant differences (p < 0.0003). Conclusion. The DCE-MRA of cerebral vessels can be considered as a biomarker of tumor neovascularization, reveals abnormal vasculature in postoperative patients with progressive disease and assess the state of hemodynamics after surgical intervention during the stabilized process.

ДК-МРА, перфузия, головной мозг, опухоли, прогрессирование, рецидив, DCE-MRA, perfusion, brain, tumor, progression, relapse

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