Blood oxygenation level-dependent MRI of cerebral gliomas during breath holding.
OBJECTIVE
To assess the cerebrovascular responses to short breath holding of cerebral gliomas using blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI).


METHODS
Six patients with a low-grade glioma and one patient with a high-grade glioma were studied using T2*-weighted echo planar imaging (EPI) during repeated periods of 15-second or 20-second breath-holding. Tumor vascularity was evaluated using dynamic susceptibility contrast perfusion MRI.


RESULTS
Increases in BOLD signal intensity during repeated breath-holding were consistently identified in patients' normal appearing gray matter, comparable with those in healthy adults. Absence of significant BOLD signal enhancement was noted both in low-grade and high-grade gliomas, which is either due to overwhelming hypoxia in a tumor, inadequacy or absence of hypercapnia-induced vasodilatation of tumor vessels, or both. Breath-hold regulated decreases in BOLD signals occurred only in the high-grade glioma, which is most likely due to the hypercapnia-induced steal effect that redistributes blood flow from tumor regions with unresponsive neovasculature to surrounding normal tissue.


CONCLUSIONS
BOLD MRI during short breath holding can disclose differential cerebrovascular response between normal tissue and cerebral glioma.
Hsu
Yuan-Yu
YY
Department of Radiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Chang
Chen-Nen
CN
Jung
Shih-Ming
SM
Lim
Kun-Eng
KE
Huang
Ju-Chuan
JC
Fang
Shin-Yi
SY
Liu
Ho-Ling
HL
D000328:Adult; D001921:Brain / Q000473:pathology*; D001932:Brain Neoplasms / Q000175:diagnosis*; D017352:Echo-Planar Imaging / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005910:Glioma / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D012119:Respiration; D013997:Time Factors
D010100:Oxygen