CONTRAST-ENHANCED MR IMAGING OF MALIGNANT BRAIN-TUMORS

  • 1 January 1985
    • journal article
    • research article
    • Vol. 6  (6) , 855-862
Abstract
Magnetic resonance (MR) imaging was performed before and serially after intravenous injection of 1 mmol/kg gadolinium-DTPA (Schering) in 17 patients with clinical and histologic diagnoses of malignant cerebral tumors. There was a decrease of 1% in T1 and 10% in T2 in normal white matter and a decrease of 8% in T1 and 14% in T2 in normal gray matter. Contrast enhancement was observed in 16 of the 17 tumors. In the region of maximal enhancement a mean decrease of 16% in T1 of 29% was seen in high-malignancy gliomas, and a mean decrease in T1 and T2. Measurements of signal intensity displayed maximal contrast enhancement with an IR 1500/500/44 sequence, much less with SE 1500/44, and least with SE 1500/80. Edema was observed on precontrast images in 14 cases, but satisfactory definition of the tumor-edema margin was only possible in four cases. After contrast enhancement this margin was defined in 10 cases. In four of the 17 cases areas of apparent "edema" seen before administration of Gd-DTPA displayed significant contrast enhancement and probably represented tumor infiltration. Comparison with CT showed a greater degree of contrast enhancement on MR images in eight cases, an equal degree in eight cases, and greater enhancement on CT in one case. Definition of the tumor-edema interface was better with MR in six cases and equal to CT in four cases. No significant toxic effects were found with the contrast agent. Gd-DTPA provided significant additional information over unenhanced MR imaging and enhanced CT.