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A Magnetic Resonance comparative study between enhancement, rCBV and ACD in brain glioblastomas.

PURPOSE
Perfusion and diffusion Magnetic Resonance Imaging (MRI) studies allow us to quantitatively evaluate the vascularisation and anaplastic grade of glioblastomas based on the regional cerebral blood volume (rCBV) and apparent diffusion coefficient (ADC) values. The aim of our study was to compare these values and enhancement % in order to determine whether enhancement of glioblastomas depends mainly on their vascularisation or anaplastic grade.


MATERIALS AND METHODS
Seventeen patients with brain glioblastomas were studied with perfusion, diffusion and T1-weighted Spin-Echo MR sequences, with and without contrast medium. The quantitative evaluations were made on solid tumour tissue regions of interest (ROI), and the high vascularisation (high rCBV) and low anaplastic grade (high ADC) ROI group was separated from the low vascularisation (low rCBV) and high anaplastic grade (low ADC) group. The mean enhancement % values of the two groups were compared by using statistical METHODS.


RESULTS
In 14 patients there were no statistically significant differences between the two groups. In one patient, the enhancement of high anaplastic grade and low vascularisation ROIs was significantly higher, whereas in two patients, the enhancement of high vascularisation and low anaplastic ROIs clearly prevailed.


CONCLUSIONS
Given that the anaplastic grade is proportional to blood-brain barrier (BBB) impairment, our results show that, in most cases, enhancement of glioblastomas is equally dependent on vascularisation and BBB impairment.