| Assessment of therapeutic response in brain tuberculomas using serial dynamic contrast-enhanced MRI. | |
MedLine Citation:
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PMID: 18374721 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To assess the most useful dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) index in the evaluation of the therapeutic response in brain tuberculoma (BT) patients. SUBJECTS AND METHODS: Twenty-three patients with 25 BT lesions were serially evaluated using DCE MRI. All lesions were classified into two groups: group I (n=15) included patients who showed clinical, as well as imaging, improvement; and group II (n=10) included patients with either clinical or radiological deterioration. The group I and group II lesions were examined for up to 12 months at 4 monthly intervals. However, the lesions in five patients of group II were excised following clinical deterioration after 4 months of therapy. The perfusion indices, i.e., relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), permeability (k(trans)), and leakage (v(e)), were quantified at each time point. The cellular, necrotic, and total volumes of lesion, together with the oedema volume, were also calculated. RESULTS: All patients in group I and three in group II showed a significant decrease in all perfusion indices, together with the oedema volume, after 1 year. In these three patients in group II, increase in rCBV was associated with increased cellular volume fraction whereas the k(trans), v(e), and oedema volume decreased significantly after 4 months. In five patients in group II who underwent excision of the lesion after 4 months of therapy due to clinical deterioration, the decrease in rCBV was associated with significant increase in k(trans) and oedema volume without any significant change in lesion volume. The rCBV correlated significantly with the cellular volume, whereas k(trans) showed a significant correlation with the v(e) and oedema volume at each time point. CONCLUSION: In BT, changes in k(trans) and oedema volume are associated with a therapeutic response at 4 months, even when there is a paradoxical increase in the lesion volume. |
Authors:
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M Haris; R K Gupta; M Husain; C Srivastava; A Singh; R K Singh Rathore; S Saksena; S Behari; N Husain; C Mohan Pandey; K Nath Prasad |
Publication Detail:
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Type: Journal Article Date: 2008-01-14 |
Journal Detail:
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Title: Clinical radiology Volume: 63 ISSN: 0009-9260 ISO Abbreviation: Clin Radiol Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-03-31 Completed Date: 2008-08-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1306016 Medline TA: Clin Radiol Country: England |
Other Details:
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Languages: eng Pagination: 562-74 Citation Subset: IM |
Affiliation:
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Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Blood Volume Brain / blood supply* Cerebrovascular Circulation Child Child, Preschool Contrast Media Female Humans Magnetic Resonance Imaging / methods* Male Treatment Outcome Tuberculoma, Intracranial / diagnosis*, therapy Tuberculosis, Meningeal / diagnosis*, therapy |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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