Published ahead of print on January 9, 2008
doi: 10.3174/ajnr.A0903
Perfusion Imaging of Brain Tumors Using Arterial Spin-Labeling: Correlation with Histopathologic Vascular Density
T. Noguchia,
T. Yoshiuraa,
A. Hiwatashia,
O. Togaoa,
K. Yamashitaa,
E. Nagaoa,
T. Shonob,
M. Mizoguchib,
S. Nagatab,
T. Sasakib,
S.O. Suzukic,
T. Iwakic,
K. Kobayashid,
F. Miharaa and
H. Hondaa
a Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
b Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
c Department of Neuropathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
d Radiological Center, Kyushu University Hospital, Fukuoka, Japan
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Fig 1. Relative maximal %Signal intensity in 4 histopathologic types of brain tumors. Statistically significant differences between hemangioblastomas and gliomas (P < .005), and meningiomas (P < .05) and schwannomas (P < .005) are revealed (Kruskal-Wallis test with Scheffé post hoc analysis).
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Fig 2. Scatter chart of %Signal intensity determined by ASL-PI and the %Vessel determined by histopathologic examination with regression lines in 35 tumors of 6 histopathologic types and 11 gliomas. Note the positive correlations between %Signal intensity and %Vessel in 35 cases ({x: %Signal intensity; y: %Vessel}, y = 9.71x + 1.49, r2 = 0.627; rs = 0.782, P < .00005) and in gliomas (y = 1.16x + 1.49, r2 = 0.514; rs = 0.773, P < .05).
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Fig 3. Scatter chart of %Signal intensity determined by ASL-PI and MIB1 index determined by histopathologic examination with a regression line in 12 gliomas. Note the positive correlation between %Signal intensity and MIB1 index in gliomas ({x: %Signal intensity; y: %Vessel}, y = 2.30x + 1.67, r2 = 0.397; rs = 0.700, P < .05).
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Fig 4. The relative maximal %Signal intensity in high- and low-grade gliomas. Note the significant difference between high- and low-grade gliomas (P < .05).
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Fig 5. A 61-year-old woman with hemangioblastoma; postcontrast T1WI (TR/TE = 525/17 ms) (A), T2WI (2500/15 ms) (B), perfusion image by ASL (C), and CD-34–immunostained histopathologic specimen with the dark gray color overlaid on vessel lumen areas (x20) (D). A, Postcontrast T1WI shows a strongly enhanced mass (arrow) in the right cerebellar hemisphere. B, T2WI shows a high-signal-intensity mass (arrow) with surrounding edema. C, Perfusion image by ASL shows remarkably high signal intensity (%Signal intensity = 524%) (arrow). D, The image analysis of the CD-34–immunostained histopathologic specimen shows attenuated vascular proliferation (%Vessel = 36.0%).
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Fig 6. A 44-year-old woman with glioblastoma; postcontrast T1WI (591/17 ms) (A), T2WI (2800/93 ms) (B), perfusion image by ASL (C), and CD-34–immunostained histopathologic specimen with the dark gray color overlaid on vessel lumen areas (x20) (D). A, Postcontrast T1WI reveals a ringlike enhancing mass (arrow) in the left cerebral hemisphere. B, T2WI shows the high-intensity mass (arrow) with peritumoral edema. C, On the perfusion image by ASL, the tumor was depicted as a high-intensity area (%Signal intensity = 265%) with a central low perfusion area (arrow). Image analysis of the CD-34–immunostained histopathologic specimen shows scattered vascular proliferation (%Vessel = 2.97%).
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