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Cao X, Lv K, Xu S, Feng Z, Yin X, Pan L, Geng D, Zhang J. Peliminary exploration on the differential diagnosis between meningioma and schwannoma using contrast-enhanced T 1WI flow-sensitive black-blood sequence. Front Oncol 2023; 12:1006190. [PMID: 36686822 PMCID: PMC9849908 DOI: 10.3389/fonc.2022.1006190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Contrast-enhanced T1WI flow-sensitive black-blood (CE-T1WI FSBB) is a newly developed sequence which had not been widely used for differential diagnosis of brain tumors. Methods To quantify the pre-operative imaging features of intratumoral microbleeds and intratumoral vessels using CE-T1WI FSBB scan and study the differences in biological behavior of meningiomas and schwannomas underlying the imaging features. Seventy-three cases of meningiomas and 24 cases of schwannomas confirmed by postoperative pathology were included. Two neuroradiologists independently counted intratumoral vessels and intratumoral microbleeds based on CE-T1WI FSBB images. The vessel density index (VDI) and microbleed density index (MDI) were the number of intratumoral vessels and the number of intratumoral microbleeds divided by the tumor volume, respectively. The consistency test of intratumoral vessel count and intratumoral microbleed count based on CE-T1WI FSBB were summarized using 2-way random intraclass correlation coefficients (ICC). Mann-Whitney U-test and chi-square test were used to determine significant differences between meningiomas and schwannomas, and fibrous meningiomas and epithelial meningiomas. P<0.05 was considered statistically significant. Results The ICC of intratumoral vessels count and intratumoral microbleeds count were 0.89 and 0.99, respectively. There were significant differences in the number of intratumoral microbleeds (P<0.01) and MDI values (P<0.01) between meningiomas and schwannomas. There were no differences in the number of intratumoral vessels (P=0.64), VDI (P=0.17), or tumor volume (P=0.33). There were also differences in the number of intratumoral microbleeds (P<0.01), the MDI value (P<0.01), and the sex of patients (P<0.05) between fibrous meningiomas and epithelial meningiomas. Discussion CE-T1WI FSBB can be a new technique for differentiating schwannomas from meningiomas, and even different types of meningiomas. Schwannomas have a higher incidence of intratumoral hemorrhage, more intratumoral microbleeds, and higher MDI values than meningiomas, which provides a new basis for preoperative differential diagnosis and treatment decisions.
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Affiliation(s)
- Xin Cao
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China,National Center for Neurological Disorders, Shanghai, China,Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China
| | - Kun Lv
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Siting Xu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhe Feng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xuyang Yin
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Lei Pan
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Daoying Geng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China,National Center for Neurological Disorders, Shanghai, China,Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China
| | - Jun Zhang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China,National Center for Neurological Disorders, Shanghai, China,Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China,*Correspondence: Jun Zhang,
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Cao X, Lv K, Yin X, Cao Y, Xu S, Feng Z, Han Y, Tang Y, Geng D, Zhang J. Preoperative Assessment of Blood Vessels and Intratumoral Microbleeds in Brain Tumors Based on a 3D Contrast-Enhanced T 1 -Weighted Flow-Sensitive Black-Blood Sequence. J Magn Reson Imaging 2022; 57:1543-1551. [PMID: 36054465 DOI: 10.1002/jmri.28415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Three-dimensional (3D) contrast-enhanced T1 -weighted flow-sensitive black-blood (CE-T1 WI FSBB) is a newly developed black blood sequence by adding motion probing gradient pulses to gradient echo (GRE) sequences, which has important value for the preoperative assessment of tumor brain blood supply vessels and intratumoral microbleeds. PURPOSE To compare 3D CE-T1 WI FSBB and 3D contrast-enhanced fast spin echo (FSE) sequence for T1 WI for preoperative assessment of blood vessels and microbleeds in brain tumors and to investigate the correlation between visible vessels and microbleeds. STUDY TYPE Prospective. SUBJECTS One hundred and seventy-five patients with brain tumors, 65 were male, 110 were female. Including histologically confirmed 73 meningiomas, 23 schwannomas, 20 gliomas, 7 hemangioblastomas, 5 metastases, 2 lymphomas, 2 hemangiopericytomas, 2 germ cell tumors, 1 craniopharyngioma, and 1 cholesteatoma. FIELD STRENGTH/SEQUENCE A 3-T, CE-T1 WI FSBB, GRE; 3-T, CE-T1 WI, FSE. ASSESSMENT Three neuroradiologists counted the number of intratumoral vessels on CE-T1 WI and CE-T1 WI FSBB images separately, and they counted the number of intratumoral microbleeds on CE-T1 WI FSBB images. Brain tumors were classified into grade I, grade II, and grade IV according to the World Health Organization (WHO) grading. Differences in the ability of CE-T1 WI FSBB and CE-T1 WI to display intratumoral vessels were compared. The mean counts of three observers were used to study the correlation between vessels and microbleeds. STATISTICAL TESTS Two-way random intraclass correlation coeficient (ICC) was used for inter-reader agreement regarding intratumoral vessel and microbleed counts, and the linear regression analysis (with F-test) was used to study the correlation between intratumoral vessels and microbleeds based on CE-T1 WI FSBB (α = 0.05). RESULTS Inter-reader agreements for intratumoral vessel count on CE-T1 WI (ICC = 0.93) and CE-T1 WI FSBB (ICC = 0.92), and the agreement for intratumoral microbleed count on CE-T1 WI FSBB (ICC = 0.99) were excellent. There were statistically significant differences in intratumoral vessel counts between CE-T1 WI and CE-T1 WI FSBB using Mann-Whitney U -test: image readers could identify more intratumoral vessels on CE-T1 WI FSBB images, particularly for meningiomas, schwannomas, gliomas, and WHO grade I tumors. The number of intratumoral vessels had a significant positive effect on the number of intratumoral microbleeds (microbleeds = 5.024 + 1.665 × vessels; F = 11.51). DATA CONCLUSION More intratumoral vessels could potentially be identified using a 3D CE-T1 WI FSBB sequence compared to a CE-T1 WI sequence, and the number of intratumoral vessels showed a positive linear relationship with the number of intratumoral microbleeds, which might suggest that brain tumors with rich blood supply were more prone to intratumoral microbleeds. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Xin Cao
- Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China.,Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China
| | - Kun Lv
- Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Xuyang Yin
- Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Yunxi Cao
- College of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai'an, Shandong Province, China
| | - Siting Xu
- Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Zhe Feng
- Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China
| | - Yan Han
- Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Ye Tang
- Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China
| | - Daoying Geng
- Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China.,Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China
| | - Jun Zhang
- Department of Radiology,Huashan Hospital,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China.,Center for Shanghai Intelligent Imaging for Critical Brain Diseases Engineering and Technology Reasearch, Shanghai, China
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