Assessment of cerebral blood volume with dynamic susceptibility contrast enhanced gradient-echo imaging.
OBJECTIVE
Dynamic susceptibility contrast (DSC) enhanced MRI was used to study relative cerebral blood volume (rCBV).


METHODS
We examined 15 healthy subjects and 47 patients with vascular stenosis or occlusion, with brain infarctions, and with cerebral neoplasms. During bolus injection of Gd-diethylenetriamine pentaacetic acid, a series of rapid T2*-weighted fast low angle shot two-dimensional images were recorded from the same slice. From these images, changes in signal intensity during bolus passage were computed pixel-by-pixel and converted into contrast agent concentration curves. Applying the principles of indicator dilution theory, images of rCBV were calculated.


CONCLUSIONS
Regions of infarctions show almost zero rCBV. In patients with high-grade vascular stenosis or occlusion a bolus delay in comparison to the unaffected side and an increased mean transit time can be observed. Some of the affected areas show an increased rCBV, which is a well-known physiological mechanism that takes place to compensate for the reduced cerebral blood pressure. In brain tumors, rCBV imaging reveals focal or homogeneous areas of increased blood volume. This can even be observed in low-grade astrocytomas with unaffected blood-brain barrier. In CBV imaging, the effects of radiotherapy on tumor tissue can be monitored as a significant decrease of rCBV in tumor tissue after therapy.
Gückel
F
F
Institut für Klinische Radiologie, Klinikum Mannheim, Klinische Fakultät II, Universität Heidelberg, Germany.
Brix
G
G
Rempp
K
K
Deimling
M
M
Röther
J
J
Georgi
M
M
D000328:Adult; D000368:Aged; D001810:Blood Volume; D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000175:diagnosis / Q000503:physiopathology*; D001932:Brain Neoplasms / Q000503:physiopathology; D002544:Cerebral Infarction / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000503:physiopathology; D002648:Child; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D011446:Prospective Studies
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA