scholarly journals Favorable Outcome in a Case of Von Balo’s Sclerosis Mimicking a Juvenile Stroke at the Onset A New Possible Role of Dynamic Susceptibility Contrast (Dsc) Perfusion-Weighted Imaging (PWI).

2021 ◽  
Author(s):  
ASSUNTA TRINCHILLO ◽  
Alessandra D'Amico ◽  
Elena Salvatore
Keyword(s):  
Favorable Outcome ◽  
Dynamic Susceptibility ◽  
Mri Imaging ◽  
Dynamic Susceptibility Contrast ◽  
Active Lesion ◽  
Perfusion Weighted Imaging ◽  
Dsc Mri ◽  
Mri Sequences ◽  
Susceptibility Contrast

Abstract We describe a juvenile stroke-like onset of Von Balò’s sclerosis, with a favorable outcome after 4 years of follow up, even if treatment’s protocols could not have been completed, because her low compliance. Following the patient with annual MRI imaging we surprisingly discovered associations between which was reported at a Perfusion-weighted Imaging (PWI) Dynamic susceptibility contrast (DSC)-MRI executed after 9 days from the exordium and patient’s clinical residues. By describing the case we focus on a new way to use PWI-DSC in order not only to determine areas of Blood-Brain-Barrier active lesion but also to have information on patients’ prognosis and to guide neurologist in his therapeutical choices. PWI can’t substitute other MRI sequences, which describe, in that moment of execution, how many cerebral areas are involved in the process of demyelization, but PWI, surely, is an excellent sequence to integrate diagnosis and improve patients’ clinical, diagnostic and therapeutic follow up.

scholarly journals Role of Dynamic Susceptibility Contrast Perfusion MRI in Glioma Progression Evaluation

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Guanmin Quan ◽  
Kexin Zhang ◽  
Yawu Liu ◽  
Jia-Liang Ren ◽  
Deyou Huang ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Cerebral Blood Volume ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Enhancement Pattern ◽  
Dsc Mri ◽  
Susceptibility Contrast ◽  
True Progression ◽  
Glioma Progression

Accurately and quickly differentiating true progression from pseudoprogression in glioma patients is still a challenge. This study aims to explore if dynamic susceptibility contrast- (DSC-) MRI can improve the evaluation of glioma progression. We enrolled 65 glioma patients with suspected gadolinium-enhancing lesion. Longitudinal MRI follow-up (mean 590 days, range: 210–2670 days) or re-operation (n = 3) was used to confirm true progression (n = 51) and pseudoprogression (n = 14). We assessed the diagnostic performance of each MRI variable and the different combinations. Our results showed that the relative cerebral blood volume (rCBV) in the true progression group (1.094, 95%CI: 1.135–1.636) was significantly higher than that of the pseudoprogression group (0.541 ± 0.154) p < 0.001 . Among the 18 patients who had serial DSC-MRI, the rCBV of the progression group (0.480, 95%CI: 0.173–0.810) differed significantly from pseudoprogression (-0.083, 95%CI: −1.138–0.620) group p = 0.015 . With an rCBV threshold of 0.743, the sensitivity and specificity for discriminating true progression from pseudoprogression were 76.5% and 92.9%, respectively. The Cho/Cr and Cho/NAA ratios of the true progression group (2.520, 95%CI: 2.331–2.773; 2.414 ± 0.665, respectively) were higher than those of the pseudoprogression group (1.719 ± 0.664; 1.499 ± 0.500, respectively) ( p = 0.001 , p < 0.001 , respectively). The areas under ROC curve (AUCs) of enhancement pattern, MRS, and DSC-MRI for the differentiation were 0.782, 0.881, and 0.912, respectively. Interestingly, when combined enhancement pattern, MRS, and DSC-MRI variables, the AUC was 0.965 and achieved sensitivity 90.2% and specificity 100.0%. Our results suggest that DSC-MRI can significantly improve the diagnostic performance for identifying glioma progression. DSC-MRI combined with conventional MRI may promptly distinguish true gliomas progression from pseudoprogression when the suspected gadolinium-enhancing lesion was found, without the need for a long-term follow-up.

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.

Attempts to improve absolute quantification of cerebral blood flow in dynamic susceptibility contrast magnetic resonance imaging: a simplified T1-weighted steady-state cerebral blood volume approach

2007 ◽  
Vol 48 (5) ◽  
pp. 550-556 ◽  
Author(s):  
R. Wirestam ◽  
L. Knutsson ◽  
J. Risberg ◽  
S. Börjesson ◽  
E.-M. Larsson ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Steady State ◽  
Water Exchange ◽  
Cerebral Blood Volume ◽  
Dynamic Susceptibility ◽  
Resonance Imaging ◽  
Dynamic Susceptibility Contrast ◽  
Dsc Mri ◽  
Contrast Magnetic Resonance ◽  
Susceptibility Contrast

Background: Attempts to retrieve absolute values of cerebral blood flow (CBF) by dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) have typically resulted in overestimations. Purpose: To improve DSC-MRI CBF estimates by calibrating the DSC-MRI-based cerebral blood volume (CBV) with a corresponding T1-weighted (T1W) steady-state (ss) CBV estimate. Material and Methods: 17 volunteers were investigated by DSC-MRI and 133Xe SPECT. Steady-state CBV calculation, assuming no water exchange, was accomplished using signal values from blood and tissue, before and after contrast agent, obtained by T1W spin-echo imaging. Using steady-state and DSC-MRI CBV estimates, a calibration factor K = CBV(ss)/CBV(DSC) was obtained for each individual. Average whole-brain CBF(DSC) was calculated, and the corrected MRI-based CBF estimate was given by CBF(ss) = K×CBF(DSC). Results: Average whole-brain SPECT CBF was 40.1±6.9 ml/min·100 g, while the corresponding uncorrected DSC-MRI-based value was 69.2±13.8 ml/min·100 g. After correction with the calibration factor, a CBF(ss) of 42.7±14.0 ml/min·100 g was obtained. The linear fit to CBF(ss)-versus-CBF(SPECT) data was close to proportionality ( R = 0.52). Conclusion: Calibration by steady-state CBV reduced the population average CBF to a reasonable level, and a modest linear correlation with the reference 133Xe SPECT technique was observed. Possible explanations for the limited accuracy are, for example, large-vessel partial-volume effects, low post-contrast signal enhancement in T1W images, and water-exchange effects.

Functional Information on Meningiomas Through Perfusion Magnetic Resonance Imaging

2009 ◽  
Vol 4 (1) ◽  
pp. 88
Author(s):  
Hao Zhang ◽  
Guixiang Zhang ◽  
Matthijs Oudkerk ◽  
◽  
◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Perfusion Mri ◽  
Perfusion Magnetic Resonance Imaging ◽  
Dynamic Susceptibility ◽  
Resonance Imaging ◽  
Dynamic Susceptibility Contrast ◽  
Dsc Mri ◽  
Susceptibility Contrast

This article focuses on the use of perfusion magnetic resonance imaging (MRI), and in particular dynamic susceptibility contrast-enhanced MRI (DSC-MRI), to assess haemodynamics in meningiomas. We first introduce the basic principles of DSC-MRI and the most popular imaging techniques and perfusion parameters for data analysis of DSC-MRI. We then review the blood supply characteristics of meningiomas and how perfusion MRI is applied in meningiomas to help the subtyping of different meningiomas and to differentiate between benign and malignant meningiomas. Our first-hand experiences are also included. We conclude that DSC perfusion MRI can provide critical information on the vascularity of meningiomas that is not available with conventional MRI. DSC perfusion MRI measurements are helpful in the pre-operative subtyping and grading of meningiomas.

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