Application of dynamic susceptibility contrast-enhanced perfusion in temporal lobe epilepsy

2013 ◽  
Vol 54 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Wu Xing ◽  
Xiaoyi Wang ◽  
Fangfang Xie ◽  
Weihua Liao
Keyword(s):  
Temporal Lobe ◽  
Control Group ◽  
Case Group ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Temporal Lobes ◽  
Dsc Mri ◽  
Contrast Enhanced ◽  
Healthy Control ◽  
Susceptibility Contrast

Background Accurately locating the epileptogenic focus in temporal lobe epilepsy (TLE) is important in clinical practice. Single-photon emission computed tomography (SPECT) and positron-emission tomography (PET) have been widely used in the lateralization of TLE, but both have limitations. Magnetic resonance perfusion imaging can accurately and reliably reflect differences in cerebral blood flow and volume. Purpose To investigate the diagnostic value of dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) in the lateralization of the epileptogenic focus in TLE. Material and Methods Conventional MRI and DSC-MRI scanning was performed in 20 interictal cases of TLE and 20 healthy volunteers. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) of the bilateral mesial temporal lobes of the TLE cases and healthy control groups were calculated. The differences in the perfusion asymmetry indices (AIs), derived from the rCBV and rCBF of the bilateral mesial temporal lobes, were compared between the two groups. Results In the control group, there were no statistically significant differences between the left and right sides in terms of rCBV (left 1.55±0.32, right 1.57±0.28) or rCBF (left 99.00±24.61, right 100.38±23.46) of the bilateral mesial temporal lobes. However, in the case group the ipsilateral rCBV and rCBF values (1.75±0.64 and 96.35±22.63, respectively) were markedly lower than those of the contralateral side (2.01± 0.79 and 108.56±26.92; P < 0.05). Both the AI of the rCBV (AIrCBV; 13.03±10.33) and the AI of the rCBF (AIrCBF; 11.24±8.70) of the case group were significantly higher than that of the control group (AIrCBV 5.55± 3.74, AIrCBF 5.12±3.48; P < 0.05). The epileptogenic foci of nine patients were correctly lateralized using the 95th percentile of the AIrCBV and AIrCBF of the control group as the normal upper limits. Conclusion In patients with TLE interictal, both rCBV and rCBF of the ipsilateral mesial temporal lobe were markedly lower than that of healthy control subjects. DSC-MRI can provide lateralization for TLE.

scholarly journals Intra-tumoural perfusion habitats showed prognostic value in glioblastoma patients

2019 ◽  
Vol 21 (Supplement_4) ◽  
pp. iv3-iv3
Author(s):  
Chao Li ◽  
Chang Sun ◽  
Shuo Wang ◽  
Stephen Price
Keyword(s):  
Cerebral Blood Volume ◽  
Cox Regression ◽  
Mean Transit Time ◽  
Tumour Microenvironment ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Post Contrast ◽  
Dsc Mri ◽  
Contrast Enhanced ◽  
Susceptibility Contrast

Abstract The perfusion within glioblastoma is associated with tumour microenvironment and may create invasive tumor habitats that could potentially be revealed by perfusion imaging. The purpose of this study is to characterize the peritumoural habitats of glioblastoma for treatment target. Dynamic susceptibility contrast-enhancement (DSC) MRI was acquired pre-operatively on 115 newly-diagnosed glioblastoma patients. All images were co-registered to post-contrast T1-weighted images. The relative cerebral blood volume (rCBV), mean transit time (MTT) and relative cerebral blood flow (rCBF) maps were generated from the DSC images. The contrast-enhanced and peritumoural tumor regions were semi-automatically segmented from the post-contrast T1-weighted and FLAIR images. To delineate the habitats of different perfusion levels, a two clusters mixture model with Gaussian distribution was fitted to the rCBV, rCBF, and MTT within both contrast-enhanced and peritumoural regions. Perfusion parameters of the identified habitats were compared, and the prognostic values of habitats were investigated using survival analysis. The results showed that although non-enhanced, the peritumoral high perfusion (PHP) habitat demonstrated similar perfusion level with the contrast high perfusion (CHP) habitat, with similar rCBV (PHP: 1.13 ± 0.18, 95% CI [1.10, 1.15]; CHP: 1.21 ± 0.25, 95% CI [1.16, 1.21]) and rCBF (PHP: 1.08 ± 0.23, 95% CI [1.05, 1.08]; CHP: 1.08 ± 0.19, 95% CI [1.05, 1.08]). Multivariate Cox regression showed that the volumes of both habitats were associated with worse patient overall survival (PHP: P = 0.032; HR= 7.09; CHP: P = 0.008; HR= 12.01). Our results suggest that the intra-tumoural perfusion habitats may potentially offer treatment targets.

scholarly journals Dynamic susceptibility contrast enhanced (DSC) MRI perfusion and plasma cytokine levels in patients after tonic-clonic seizures

2017 ◽  
Vol 51 (3) ◽  
pp. 277-285
Author(s):  
Tatjana Filipovic ◽  
Katarina Surlan Popovic ◽  
Alojz Ihan ◽  
David Bozidar Vodusek
Keyword(s):  
Plasma Level ◽  
Blood Brain Barrier ◽  
Brain Barrier ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Blood Brain ◽  
Dsc Mri ◽  
Contrast Enhanced ◽  
Clonic Seizures ◽  
Susceptibility Contrast

Abstract Background Inflammatory events in brain parenchyma and glial tissue are involved in epileptogenesis. Blood concentration of cytokines is shown to be elevated after tonic-clonic seizures. As a result of inflammation, blood-brain barrier leakage occurs. This can be documented by imaging techniques, such is dynamic susceptibility contrast enhanced (DSC) MRI perfusion. Our aim was to check for postictal brain inflammation by studying DSC MRI perfusion and plasma level of cytokines. We looked for correlations between number and type of introducing seizures, postictal plasma level of cytokines and parameters of DSC MRI perfusion. Furthermore, we looked for correlation of those parameters and course of the disease over one year follow up. Patients and methods We prospectively enrolled 30 patients, 8–24 hours after single or repeated tonic-clonic seizures. Results 25 of them had normal perfusion parameters, while 5 had hyperperfusion. Patients with hyperperfusion were tested again, 3 months later. Two of 5 had hyperperfusion also on control measurements. Number of index seizures negatively correlated with concentration of proinflammatory cytokines IL-10, IFN-ϒ and TNF-α in a whole cohort. In patients with hyperperfusion, there were significantly lower concentrations of antiinflammatory cytokine IL-4 and higher concentrations of proinflammatory TNF-a. Conclusions Long lasting blood- brain barrier disruption may be crucial for epileptogenesis in selected patients.

scholarly journals Assessment of the Agreement between Cerebral Hemodynamic Indices Quantified Using Dynamic Susceptibility Contrast and Dynamic Contrast-enhanced Perfusion Magnetic Resonance Imagings

2018 ◽  
Vol 8 ◽  
pp. 2 ◽  
Author(s):  
Seyed Salman Zakariaee ◽  
Mohammad Ali Oghabian ◽  
Kavous Firouznia ◽  
Guive Sharifi ◽  
Farshid Arbabi ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Intraclass Correlation ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Dce Mri ◽  
Cerebral Hemodynamic ◽  
Dynamic Contrast Enhanced ◽  
Dsc Mri ◽  
Contrast Enhanced ◽  
Susceptibility Contrast

Background: Brain tumor is one of the most common tumors. A successful treatment might be achieved with an early identification. Pathological investigation as the gold standard method for tumor identification has some limitations. Noninvasive assessment of tumor specifications may be possible using perfusion-weighted magnetic resonance imaging (MRI). Cerebral blood volume (CBV) and cerebral blood flow (CBF) could be calculated based on dynamic contrast-enhanced MRI (DCE-MRI) in addition to dynamic susceptibility contrast MRI (DSC-MRI) modality. Each category of the cerebral hemodynamic and permeability indices revealed the specific tumor characteristics and their collection could help for better identification of the tumor. Some mathematical methods were developed to determine both cerebral hemodynamic and permeability indices based on a single-dose DCE perfusion MRI. There are only a few studies available on the comparison of DSC- and DCE-derived cerebral hemodynamic indices such as CBF and CBV. Aim: The objective of the study was to validate first-pass perfusion parameters derived from T1-based DCE method in comparison to the routine T2*-based DSC protocol. Materials and Methods: Twenty-nine patients with brain tumor underwent DCE- and DSC-MRIs to evaluate the agreement between DSC- and DCE-derived cerebral hemodynamic parameters. Agreement between DSC- and DCE-derived cerebral hemodynamic indices was determined using the statistical method described by Bland and Altman. The reliability between DSC- and DCE-derived cerebral hemodynamic indices was measured using the intraclass correlation analysis. Results: The achieved magnitudes for DCE-derived CBV (gray matter [GM]: 5.01 ± 1.40 mL/100 g vs. white matter [WM]: 1.84 ± 0.74 mL/100 g) and DCE-derived CBF (GM: 60.53 ± 12.70 mL/100 g/min vs. WM: 32.00 ± 6.00 mL/100 g/min) were in good agreement with other studies. The intraclass correlation coefficients showed that the cerebral hemodynamic indices could accurately be estimated based on the DCE-MRI using a single-compartment model (>0.87), and DCE-derived cerebral hemodynamic indices are significantly similar to the magnitudes achieved based on the DSC-MRI (P < 0.001). Furthermore, an acceptable agreement was observed between DSC- and DCE-derived cerebral hemodynamic indices. Conclusion: Based on the measurement of the cerebral hemodynamic and blood–brain barrier permeability using DCE-MRI, a more comprehensive collection of the physiological parameters cloud be achieved for tumor evaluations.

Efficacy of endovascular intratumoral embolization for meningioma: assessment using dynamic susceptibility contrast-enhanced perfusion-weighted imaging

2021 ◽  
pp. neurintsurg-2020-017116
Author(s):  
Katsunori Asai ◽  
Hajime Nakamura ◽  
Yoshiyuki Watanabe ◽  
Takeo Nishida ◽  
Mio Sakai ◽  
...  
Keyword(s):  
Intracranial Meningioma ◽  
Preoperative Embolization ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Perfusion Weighted Imaging ◽  
Contrast Enhanced ◽  
Before And After ◽  
Reduction Effect ◽  
Susceptibility Contrast ◽  
Bare Platinum Coils

BackgroundIn preoperative embolization for intracranial meningioma, endovascular intratumoral embolization is considered to be more effective for the reduction of tumorous vascularity than proximal feeder occlusion. In this study, we aimed to reveal different efficacies for reducing tumor blood flow in meningiomas by comparing endovascular intratumoral embolization and proximal feeder occlusion using dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI).Methods28 consecutive patients were included. DSC-PWI was performed before and after embolization for intracranial meningiomas. Normalized tumor blood volume (nTBV) of voxels of interest of whole tumors were measured from the DSC-PWI data before and after embolization. ΔnTBV% was compared between the cases that received intratumoral embolization and proximal feeder occlusion.ResultsΔnTBV% in the intratumoral embolization group (42.4±29.8%) was higher than that of the proximal feeder occlusion group (15.3±14.3%, p=0.0039). We used three types of embolic materials and ΔnTBV% did not differ between treatments with or without the use of each material: 42.8±42.4% vs 28.7±20.1% for microspheres (p=0.12), 36.1±20.6% vs 28.1±41.1% for n-butyl cyanoacrylate (p=0.33), and 32.3±37.3% vs 34.1±19.0% for bare platinum coils (p=0.77).ConclusionsThe flow reduction effect of intratumoral embolization was superior to that of proximal feeder occlusion in preoperative embolization for intracranial meningioma in an assessment using DSC-PWI.

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