Distinguishing of primary cerebral lymphoma from high-grade glioma with perfusion-weighted magnetic resonance imaging.
To assess the usefulness of perfusion-weighted echo-planar magnetic resonance imaging in the differential diagnosis of primary supratentorial lymphoma (PCNSL) and glioblastoma (GBM), 12 patients with a PCNSL and 12 with a GBM were examined using a 1.5 T magnetic resonance (MR) imager. With dynamic-susceptibility contrast MR imaging the intensity-time curves of each tumor were analyzed, and we determined the relative regional cerebral blood volume ratios (rrCBV [tumor/contralateral white matter (WM)]) to find out whether these parameters could be used to separate PCNSL from GBM. The maximum rrCBV ratio in the PCNSL was significantly lower than that of the GBM (P<0.0001). Comparing the intensity-time curves for the two tumor groups, the PCNSL showed a characteristic type of curve with a significant increase in signal intensity above the baseline due to massive leakage of contrast media into the interstitial space. PCNSL tend to have low maximum CBV ratios and typical intensity-time curves. These two parameters may be useful in distinguishing PCNSL from GBM.
Hartmann
Marius
M
Division of Neuroradiology, Department of Neurology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. marius_hartmann@med.uni-heidelberg.de
Heiland
Sabine
S
Harting
Inga
I
Tronnier
Volker M
VM
Sommer
Clemens
C
Ludwig
Roman
R
Sartor
Klaus
K
D001932:Brain Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005910:Glioma / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D012720:Severity of Illness Index; D015173:Supratentorial Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000473:pathology