The aims of the present study were to determine the perfusion characteristics of several types of intraventricular tumors and to evaluate the usefulness of dynamic contrast-enhanced MRI in making the differential diagnosis.
A total of 28 patients with intraventricular tumors (five meningiomas, five papillomas, three ependymomas, four subependymomas, seven central neurocytomas, two subependymal giant cell astrocytomas and two metastases) underwent conventional and dynamic susceptibility contrast-enhanced MRI. Cerebral blood volume (CBV) maps were obtained and the relative CBV (rCBV) calculated for each tumor. Mean rCBVmax values were compared across the different types of tumors (ANOVA, P=0.05).
Intraventricular tumors presented with three different patterns of vascularization: highly vascularized tumors (mean rCBVmax>3), including papillomas, meningiomas and renal carcinoma metastases; poorly vascularized tumors (mean rCBVmax<2), including ependymomas and subependymomas; and intermediately vascularized tumors (mean rCBVmax>2 but<3), including central neurocytomas and lung metastases. There was a significant difference between the highly vascularized (papillomas, meningiomas) and poorly vascularized (subependymomas) tumors. In cases of suspected meningioma, papilloma or neurocytoma, low rCBV values (<3) point to a diagnosis of neurocytoma rather than either of the other tumor types.
Susceptibility contrast-enhanced MRI can provide additional information on the vascularization of intraventricular cerebral tumors and may help in making the differential diagnosis.Le texte complet de cet article est disponible en PDF.
Keywords : Intraventricular tumors, Magnetic resonance imaging, Perfusion imaging