[Value of relative cerebral blood volume measurement using perfusion MRI in glioma management].
BACKGROUND
Neoangiogenesis is a critical feature that can differentiate high-grade from low-grade glioma. Conventional MR imaging does not assess this histological feature accurately. The goal of this study was to evaluate the gain in relative cerebral blood volume measurement using perfusion MRI in the management of cerebral gliomas.


METHODS
Between 1998 and 2001, 32 histologically proven glial tumors were assessed by perfusion MRI using echoplanar imaging (EPI) and gradient-echo techniques. Relative cerebral blood volume (rCBV) was measured in all patients and compared to histological data.


RESULTS
rCBV values were significantly correlated to histological grading in all 32 patients (P<0.001). Mean rCBV values were 8.74 (+/-3.79) for glioblastomas, 7.37 (+/-2.83) for anaplastic gliomas and 0.84 (+/-0.61) for low-grade gliomas. Mean rCBV values were significantly different between low- and high-grade gliomas, making it possible to determine a threshold (2.5-3) that can separate these two types of lesion. In determining the histological grading, rCBV was shown to be significantly more accurate than conventional MRI (P<0.005).


CONCLUSIONS
Perfusion MRI using the EPI technique reliably assesses tumoral neoangiogenesis in gliomas preoperatively. The specificity and sensitivity of this technique make this radiological modality a valuable tool in the assessment of cerebral gliomas.
Département de neurochirurgie, hôpital la Timone, 264, rue Saint-Pierre, 13005 Marseille cedex 05, France. philippe.metellus@mail.ap-hm.fr
P
P
Metellus
G
G
Dutertre
C
C
Mekkaoui
I
I
Nanni
S
S
Fuentes
A
A
Ait-Ameur
O
O
Chinot
H
H
Dufour
D
D
Figarella-Branger
Y-S
YS
Cordoliani
F
F
Grisoli
D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000473:pathology*; D001932:Brain Neoplasms / Q000098:blood supply* / Q000473:pathology; D002560:Cerebrovascular Circulation; D017352:Echo-Planar Imaging; D005260:Female; D005910:Glioma / Q000098:blood supply* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000473:pathology