Quantitation of peritumoural oedema and the effect of steroids using NMR-relaxation time imaging and blood-brain barrier analysis.
A new method of in vivo quantitation of peritumoural brain oedema using NMR relaxation time imaging (T1-maps) and Gd-DTPA-enhanced Blood-Tumour-Barrier (BTB) analysis is presented. The method is based on image pixel histogram analysis and a fast imaging method combined with arterial [Gd-DTPA]-measurement. The method was applied in 26 brain tumour patients, studied prior to--and 1, 3 and 7 days after initiation of dexamethasone. Oedema resorption rate following dexamethasone treatment was almost equal in glioblastomas and metastases, mean T1 being reduced by ca. 12% in 7 days. In meningiomas no significant changes in peritumoural oedema could be detected. Simultaneous BTB-analysis was obtained in 4 patients showing correlation between oedema resorption in vivo and reduction of BTB transport rate constant Ki after 7 days of steroid treatment. This method is a powerful tool in quantitation and monitoring of brain oedema in vivo, as both steroid influence on oedema resorption and on BTB-defect can be monitored simultaneously.
Department of Neurosurgery, Arhus University Hospital, Denmark.
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Andersen
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Astrup
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Gyldensted
D001812:Blood-Brain Barrier / Q000187:drug effects* / Q000502:physiology; D001929:Brain Edema / Q000188:drug therapy* / Q000503:physiopathology; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000556:secondary; D003287:Contrast Media; D003907:Dexamethasone / Q000627:therapeutic use*; D019786:Gadolinium DTPA; D005909:Glioblastoma / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008577:Meningeal Neoplasms / Q000188:drug therapy / Q000503:physiopathology; D008579:Meningioma / Q000188:drug therapy / Q000503:physiopathology; D009942:Organometallic Compounds / Q000493:pharmacokinetics; D004369:Pentetic Acid / Q000031:analogs & derivatives / Q000493:pharmacokinetics
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D003907:Dexamethasone; D019786:Gadolinium DTPA