Preliminary Application Of Intra-operative Magnetic Resonance Perfusion Weighted Imaging In The Surgery Of Nonenhancing Gliomas

Objective:To study effect that MR perfusion weighted imaging to estimate preoperatively the grade of non-enhancing gliomas. And predict the reliability of performing PWI and using it to guide the operation intraoperatively. Methods:In the first part,36 adults with nonenhancing supratentorial gliomas on conventional MR imaging were examined. Preoperative MR imaging used conventional MR imaging and a dynamic first-pass gadolinium-enhanced PWI scan, then perform the operation and obtain the specimens, histopathological examination and semiquantitative grading of vascular endothelial growth factor immunoreactivity were applied.In the second part,5 adults with nonenhancing supratentorial gliomas on conventional MR imaging were examined. Preoperative MR imaging used conventional MR imaging and a dynamic first-pass gadolinium-enhanced PWI scan, all patients were resected the part of lesions; and intraoperative MR imaging used the same the sequences like Preoperative MR imaging, then the residual gliomas revealed in PWI were marked in the neuronavigation, after that the operation was performed again. The specimens obtained from before and after iMR PWI were examined like the first part. Results:In the first part, among rCBV measurements,VEGF expression,and histopathologic grade have the positive correlation in nonenhencing gliomas, the gliomas with high rCBV values had malignant biological behavior positive VEGF immunoreactivity, p<0.05.In the second part, intraoperative perfusion weighted imaging and preoperative perfusion weighted imaging were consistent, the two specimens had the same histopathologic results, the residual gliomas were not found in MR imaging. Conclusions:PWI can add available information to the preoperative assessment of nonenhancing gliomas, and may add useful data to the intraoperative resection of gliomas totally.