Abstract
Purpose
To investigate the contribution of perfusion‐weighted MR imaging (PWI) by using the relative cerebral blood volume (rCBV) ratio in the differential diagnosis of various intracranial space‐occupying lesions.
Materials and Methods
This study involved 105 patients with lesions (high‐grade glioma (N = 26), low‐grade glioma (N= 11), meningioma (N = 23), metastasis (N = 25), hemangioblastoma (N = 6), pyogenic abscess (N = 4), schwannoma (N = 5), and lymphoma (N = 5)). The patients were examined with a T2*‐weighted (T2*W) gradient‐echo single‐shot EPI sequence. The rCBV ratios of the lesions were obtained by dividing the values obtained from the normal white matter. Statistical analysis was performed with the Mann‐Whitney U‐test. A P‐value less than 0.05 was considered statistically significant.
Results
The rCBV ratio was 5.76 ± 3.35 in high‐grade gliomas, 1.69 ± 0.51 in low‐grade gliomas, 8.02 ± 3.89 in meningiomas, 5.27 ± 3.22 in metastases, 11.36 ± 4.41 in hemangioblastomas, 0.76 ± 0.12 in abscesses, 1.10 ± 0.32 in lymphomas, and 3.23 ± 0.81 in schwannomas. The rCBV ratios were used to discriminate between 1) high‐ and low‐grade gliomas (P < 0.001), 2) hemangioblastomas and metastases (P< 0.05), 3) abscesses from high‐grade gliomas and metastases (P < 0.001), 4) schwannomas and meningiomas (P < 0.001), 5) lymphomas from high‐grade gliomas and metastases (P < 0.001), and 6) typical meningiomas and atypical meningiomas (P < 0.01).
Conclusion
rCBV ratios can help discriminate intracranial space‐occupying lesions by demonstrating lesion vascularity. It is possible to discriminate between 1) high‐ and low‐grade gliomas, 2) hemangioblastomas and other intracranial posterior fossa masses, 3) abscesses from high‐grade gliomas and metastases, 4) schwannomas and meningiomas, 5) lymphomas and high‐grade gliomas and metastases, and 6) typical and atypical meningiomas. J. Magn. Reson. Imaging 2006. © 2006 Wiley‐Liss, Inc.