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Values of multimodal magnetic resonance imaging (MRI) for identification and diagnosis of demyelinating pseudotumor (DPT) and glioma
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Y. Chen   , L. Wei , C. Zheng , S. Zhan , S. Chen , X. Yang |
| Department of Human Anatomy, Fujian Medical University, Fuzhou,350000, Fujian Province, China , 1574523258@qq.com |
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Abstract: (12 Views) |
Background: This to research aims to evaluate values of conventional MRI and multimodal MRI for identification and diagnosis of tumor-like demyelinating lesions (TDL), also referred to as demyelinating pseudotumor (DPT), and glioma, with a focus on imaging-based differentiation between the two conditions. Materials and Methods: Conventional MRI sequences including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fluid-attenuated inversion recovery (FLAIR), and contrast-enhanced T1WI, as well as multimodal MRI sequences including diffusion-weighted imaging (DWI), susceptibility-weighted imaging (SWI), magnetic resonance spectroscopy (MRS), and dynamic susceptibility contrast MRI (DSC-MRI), were retrospectively analyzed in 61 patients with pathologically confirmed TDL and 66 patients with glioma. Results: On conventional MRI, glioma lesions were significantly larger than TDL lesions (mean diameter 41.3 mm vs. 24.4 mm, p<0.001), more frequently involved the cerebral cortex (80.3% vs. 31.1%), and exhibited greater perilesional edema and mass effect (p<0.001). TDL lesions more commonly demonstrated open-ring enhancement (54.1% vs. 19.7%, p<0.001) and a central vein sign on SWI (27.9% vs. 7.6%, p<0.05). MRS revealed significantly higher choline (Cho)/N-acetylaspartate (NAA) and Cho/creatine (Cr) ratios and lower NAA/Cr ratios in glioma compared to TDL (p<0.05). DSC-MRI demonstrated hyperperfusion in all examined glioma lesions (9/9) versus hypoperfusion in the majority of TDL lesions (7/8, p<0.001). Conclusion: The combination of conventional MRI and multimodal MRI sequences-particularly open-ring enhancement on contrast-enhanced T1WI, the central vein sign on SWI, metabolite ratios (Cho/NAA, Cho/Cr, NAA/Cr) on MRS, and perfusion patterns on DSC-MRI-provides significant discriminative value for differentiating TDL from glioma, and is superior to reliance on conventional MRI alone. |
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| Keywords: Demyelinating pseudotumor, tumor-like demyelinating lesions, glioma, magnetic resonance imaging, multimodal MRI. |
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Full-Text [PDF 963 kb]
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Type of Study: Original Research |
Subject:
Radiation Biology
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