The Clinical Study Of Intracerebral Astrocytomas With MR Imaging

Candidate: Shen BaumTutor: Zhou Dai Ding YiTo study astrocytomas and the conrrelation between MRI. (1)MR imaging forprognosis of the Pathological Grades of Astrocytoma. (2) Assessment of the Pathological Grades of Astrocytoma Using Gd-DTPA Dynamic MRI. (3)Comparison of MRI Appearances and pathology of Peritumoral Edema, brain tumor interfaces in Astrocytomas. (4)Pre-and postsurgical location and evaluation of the motor hand area with functional MR imaging in patients with intracerebral gliomas. (5) Dynamic MR imaging in rat glioma model before and after radiotherapy. (6)Dynamic MR imaging in intracranial glioma befor and after therapy. MR imaging classification plays an important role in the proper choice of treatment method. The whole project consist of Six parts.Part I: MR imaging forprognosis of the Pathological Grades ofAstrocytomaThis paper analyzed the MRI in a group of 42 pathologically verified supratentorial astrocytic gliomas.To evaluate the usefulness MRI score for identif^ying tumor tissue characteristics. Including 16 lowgrade (LGA), 13 anaplastic (AA) and 14 glioblastoma multiformes (GBM) astrocytomas were examined with a GE Vectra o.5T supercond statistically. The mean values of LGA, AA and GBM were 0.49? uctive MR imager. Nine MRJ criteria were used: heterogeneity (HET), cystformallen or necrosis (CN), haemorrhage (I-LEM), crossing the middline (CM), edema or mass effect (EM), border definition (BD), flow void (FV), degree (CE-D) and heterogeneity of enhancement (CE-RET). Each of the criteria was scored and analyzed.20, 1.2?.17 and 1.47+0.34 respectively. The MIRI score increased with the pathological grades-4-aii^mma MRI ^WF^P<0.O1-0.00l. CN and FV were significantly higher in GBM than AA.CE-D, HET, EM, CN and CE-RET thus proved to be related to thepathological grade by a multiple regression analysis (P<0.00 1).Part 11: Assessment of the Pathological Grades of AstrocytomaUsing Gd-DTPA Dynamic MfflTo evaluate efficacy of Gd-DTPA the dynamic enhanced M1RI in diagnosing of the pathological grades of astrocytoma. Dynamic GRE IvIRI was performed after bolus injection of 0.1 5mmollkg Gd-DTPA, 30 patients with intracranial astrocuytoma using a 0.5T and 1 .5T MR unit (GE Vectra and Siemems). Contrast enhancement ratio-time (CER-T) curves, enhancement and maximum contrast enhancement ratio (MCER) of tumor were analyzed. Including 10 low-grade astrocytic goliomas (LGA), 10 anaplastic (AA) and 10 glioblastom multiformes (GBM). The differences relaxation rat time of change in the T2 were significant among the three types of glioblastom multiformes (GBM) vs low-grade astrocytomas, P<0.O0 1; glioblastom multiformes (GBM) vs anaplastic (AA), P<0.005; and nanplastic (AA) vs low-grade astrocytomas, P<0.02; and indicated differences invascularity.Part III: Comparison of MRI Appearances and pathology of Peritumoral Edema, brain tumor interfaces in AstrocytomasTo study the peritumoral edema and brain tumor interfaces in astrocytomas and the correlation between M1RI, the findings of operation and histology. Peritumoral edema and size of the tumor in 84 astrocytomas was studied with MRI, and compared with theirfindings in operation and histology. Grade I astroglioma demonstrated mild edema, size of the tumor, while grade II-IV showed marked edema. The greater the tumor size was, the more severe edema it carried. CE-D, HETas proved to be related to pathological grade by a multiple regression analysis (P<0.001).-5?Part 1V: Pre-and postsurgical location and evaluation of the motor hand area with functional MR imaging in patients with ⁱntracerebraI gliomasTo examine the intracerebral glioma before and after operation by functional MRI with BOLD technique, and to map the brain activation images of the patients on general MR imaging 13 patients had lesions involving the frontal and/or parietal lobs in one side of the cerebral hemispheres, and the lesions included 15 tumors (13 gliomas; 2 meringiomas), MSEPI...