Effect of Age and Tumor Grade on BOLD Functional MR Imaging in Preoperative Assessment of Patients...

Effect of Age and Tumor Grade on BOLD Functional MR Imaging in Preoperative Assessment of Patients

with Glioma

September 2008 Radiology, 248 ,971-978.

glioma 胶质瘤 BOLD blood oxygen level dependent 血氧水平依赖法histopathological [histəupæθəlɔdʒikəl] 组织病理学说的 motor [‘məutə] 运动的 ; 运动神经的

cortices [kɔ:tisi:z] 皮质 additive ['æditiv] 附加的multiform 多样的 ; 繁杂的superimpose [,sju:pərim'pəuz] vt.

1. 把 ... 放置在上面重叠 ; 加上去2. 【电影】【电视】叠印equivalent [i'kwivələnt] 相等的 , 相同的 , 等价的 , 等值的 ; 等量的 ; 等效的

Abstract

• Purpose: To retrospectively determine if there was a combined effect of advanced age and increased tumor grade on blood oxygen level–dependent (BOLD) functional magnetic resonance (MR) imaging signal intensity (SI) in patients with gliomas.

Materials and Methods

Data from 39 patients (27 men, 12 women; age range, 19–78 years) who had histopathologically confirmed gliomas and who underwent surgery after preoperative functional MR imaging were analyzed.

Fourteen patients had grade II or grade III gliomas, and 25 patients had grade IV gliomas. A change in BOLD SI was measured in motor cortices of tumor-containing and non–tumor-containing hemispheres. The effect of age and tumor grade, both individually and together, on BOLD functional MR SI was assessed with t tests and regression analysis.

Results

In patients with grade IV gliomas, SI change was lower in the tumor-containing hemisphere than in the non–tumor-containing hemisphere (P = .012). SI change decreased with increased age in the tumor-containing hemisphere in patients with grade II or III gliomas (P = .032) and in the non–tumor-containing hemisphere in patients with grade IV gliomas (P = .026).

While advanced age and increased glioma grade reduced SI change, the combined effect of these factors was not additive. In patients with grade IV gliomas, tumor presence reduced SI change, but the level of reduction was uniform across all ages and did n

ot correlate with age (P = .541).

(a–c) Right glioblastoma multiforme in a 72-year-old man (patient 36). Axial functional MR images obtained with the T2*-weighted gradient-echo echo-planar sequence are superimposed on anatomic reference images obtained with the T1-weighted spin-echo sequence.

AbstractColor represents SI change:

red = 1.5%–2.0% change, red-orange = 2.1%–3.0% change, orange = 3.1%–4.0% change, green = 4.1%–5.0% change, yellow = 5.1%–6.0% change. In older patients, SI change in the tumor-containing hemisphere is similar to that in the non–tumor-containing hemisphere, as demonstrated by the similar degree of coloration in both hemispheres

Left glioblastoma multiforme in a 37-year-old man. Axial functional MR images obtained with a T2*-weighted gradient-echo echo-planar sequence superimposed on T1-weighted spin-echo anatomic reference images.

Color represents SI change: red = 1.5%–2.0% change, red-orange = 2.1%–3.0% change, orange = 3.1%–4.0% change, green = 4.1%–5.0% change, yellow = 5.1%–6.0% change. In younger patients, SI change in the tumor-containing hemisphere is less than that in the non–tumor-containing hemisphere, as demonstrated by the different degrees of coloration in the hemispheres.

Conclusion In older patients with grade IV gliomas, B

OLD SI is equivalent to that measured in younger patients with grade IV gliomas. Advanced age and tumor grade do not have a combined effect for reduction of BOLD SI. Rather, in patients with grade IV gliomas, tumor grade played a dominant role in reduction of SI change, whereas in patients with grade II and III gliomas, reduction of SI change correlated with only advanced age.

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