title: Differentiation of tumefactive demyelinating lesions from high-grade gliomas with the use of diffusion tensor imaging.
abstract: OBJECTIVE
  TDLs may be indistinguishable from high-grade gliomas on conventional MR imaging. The role of DTI in differentiating TDLs from high-grade gliomas is not clear, and quantitative comparison between the 2 has not been reported. Here we aimed to differentiate TDLs from high-grade gliomas by using DTI.
  
  
  METHODS
  DTI was performed in 8 TDLs and 13 high-grade gliomas. The presence of 3 findings (ie, intralesional hyperintensities on the FA map, restricted diffusion in the lesion periphery, and a perilesional hyperintense FA rim) was assessed by visual inspection. The FA and MD values were measured in the central nonenhancing portion, peripheral enhancing portion, and perilesional edema for each lesion and compared between the 2 groups respectively.
  
  
  RESULTS
  TDLs had a significantly higher incidence of intralesional hyperintensities on FA maps (P = .049) but a lower incidence of a perilesional hyperintense FA rim (P < .001), compared with those of high-grade gliomas on visual inspection. TDLs had significantly higher FA (P = .004) and lower MD (P = .001) values in the peripheral enhancing portions of the lesions compared with those of high-grade gliomas. In perilesional edema, FA values were significantly higher in high-grade gliomas (P = .001).
  
  
  CONCLUSIONS
  DTI is helpful in differentiating TDLs from high-grade gliomas by using visual inspection and quantitative analysis.
authors.affiliation: Departments of Medical Imaging and Intervention, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou, Taiwan.
authors.forename: C H
authors.initials: CH
authors.lastname: Toh
authors.forename: K-C
authors.initials: KC
authors.lastname: Wei
authors.forename: S-H
authors.initials: SH
authors.lastname: Ng
authors.forename: Y-L
authors.initials: YL
authors.lastname: Wan
authors.forename: M
authors.initials: M
authors.lastname: Castillo
authors.forename: C-P
authors.initials: CP
authors.lastname: Lin
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology*; D003711:Demyelinating Diseases / Q000473:pathology*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005910:Glioma / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity