Document Detail


Effects of dexamethasone on cerebral perfusion and water diffusion in patients with high-grade glioma.
MedLine Citation:
PMID:  16484419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The mechanisms by which the glucocorticoid dexamethasone produces its therapeutic action in patients with intracranial tumors still remain unclear. The purpose of this study was to investigate whether dexamethasone affects cerebral perfusion and water molecule diffusion by using quantitative dynamic susceptibility contrast perfusion MR imaging (DSC-MR imaging) and diffusion tensor MR imaging (DT-MR imaging). METHODS: Ten consecutive patients with glioblastoma multiforme underwent DSC-MR imaging and DT-MR imaging before and 48-72 hours after dexamethasone treatment (16 mg/day). Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and water mean diffusivity (<D>) were measured for enhancing tumor, nonenhancing peritumoral edematous brain, and normal-appearing contralateral white matter before and after steroid therapy. The percentage change in CBF, CBV, MTT, and <D> for the 3 tissue types was calculated for each patient, a mean value obtained for the population, and the statistical significance determined by using a paired-samples Student t test. RESULTS: After dexamethasone treatment, there was no significant change in tumor CBF, CBV, or MTT. Edematous brain CBV and MTT were also unchanged. There was, however, an increase in edematous brain CBF (11.6%; P = .05). <D> was reduced in both enhancing tumor (-5.8%; P = .001) and edematous brain (-6.0%; P < .001). There was no significant change in CBF, CBV, MTT, or <D> for normal-appearing contralateral white matter after treatment. CONCLUSION: These data suggest that dexamethasone does not significantly affect tumor blood flow but may, by reducing peritumoral water content and local tissue pressure, subtly increase perfusion in the edematous brain.
Authors:
M E Bastin; T K Carpenter; P A Armitage; S Sinha; J M Wardlaw; I R Whittle
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  27     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-02-17     Completed Date:  2006-04-13     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  402-8     Citation Subset:  IM    
Affiliation:
Department of Medical and Radiological Sciences, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Flow Velocity / drug effects
Blood Volume / drug effects
Blood-Brain Barrier / drug effects*
Brain / blood supply*
Brain Edema / diagnosis,  drug therapy
Brain Neoplasms / blood supply*,  drug therapy
Contrast Media
Dexamethasone / therapeutic use*
Diffusion Magnetic Resonance Imaging / methods*
Female
Gadolinium DTPA / diagnostic use
Glioblastoma / blood supply*,  drug therapy
Humans
Image Enhancement / methods*
Image Processing, Computer-Assisted / methods*
Male
Middle Aged
Prospective Studies
Regional Blood Flow / drug effects
Sensitivity and Specificity
Chemical
Reg. No./Substance:
0/Contrast Media; 50-02-2/Dexamethasone; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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