Sana Mohammadi MD, Sadegh Ghaderi PhD, Ali Fathi Jouzdani MD, Iman Azinkhah MSc, Sanaz Alibabaei MSc, Mobin Azami MD, Vida Omrani MSc
{"title":"利用脑灌注相关参数（脑血容量和脑血流量）区分高级别胶质瘤和脑转移瘤：灌注加权磁共振成像技术的系统性回顾和元分析》。","authors":"Sana Mohammadi MD, Sadegh Ghaderi PhD, Ali Fathi Jouzdani MD, Iman Azinkhah MSc, Sanaz Alibabaei MSc, Mobin Azami MD, Vida Omrani MSc","doi":"10.1002/jmri.29473","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Background</h3>\n \n <p>Distinguishing high-grade gliomas (HGGs) from brain metastases (BMs) using perfusion-weighted imaging (PWI) remains challenging. PWI offers quantitative measurements of cerebral blood flow (CBF) and cerebral blood volume (CBV), but optimal PWI parameters for differentiation are unclear.</p>\n </section>\n \n <section>\n \n <h3> Purpose</h3>\n \n <p>To compare CBF and CBV derived from PWIs in HGGs and BMs, and to identify the most effective PWI parameters and techniques for differentiation.</p>\n </section>\n \n <section>\n \n <h3> Study Type</h3>\n \n <p>Systematic review and meta-analysis.</p>\n </section>\n \n <section>\n \n <h3> Population</h3>\n \n <p>Twenty-four studies compared CBF and CBV between HGGs (<i>n</i> = 704) and BMs (<i>n</i> = 488).</p>\n </section>\n \n <section>\n \n <h3> Field Strength/Sequence</h3>\n \n <p>Arterial spin labeling (ASL), dynamic susceptibility contrast (DSC), dynamic contrast-enhanced (DCE), and dynamic susceptibility contrast-enhanced (DSCE) sequences at 1.5 T and 3.0 T.</p>\n </section>\n \n <section>\n \n <h3> Assessment</h3>\n \n <p>Following the PRISMA guidelines, four major databases were searched from 2000 to 2024 for studies evaluating CBF or CBV using PWI in HGGs and BMs.</p>\n </section>\n \n <section>\n \n <h3> Statistical Tests</h3>\n \n <p>Standardized mean difference (SMD) with 95% CIs was used. Risk of bias (ROB) and publication bias were assessed, and <i>I</i><sup>2</sup> statistic was used to assess statistical heterogeneity. A <i>P</i>-value<0.05 was considered significant.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>HGGs showed a significant modest increase in CBF (SMD = 0.37, 95% CI: 0.05–0.69) and CBV (SMD = 0.26, 95% CI: 0.01–0.51) compared with BMs. Subgroup analysis based on region, sequence, ROB, and field strength for CBF (HGGs: 375 and BMs: 222) and CBV (HGGs: 493 and BMs: 378) values were conducted. ASL showed a considerable moderate increase (50% overlapping CI) in CBF for HGGs compared with BMs. However, no significant difference was found between ASL and DSC (<i>P</i> = 0.08).</p>\n </section>\n \n <section>\n \n <h3> Data Conclusion</h3>\n \n <p>ASL-derived CBF may be more useful than DSC-derived CBF in differentiating HGGs from BMs. This suggests that ASL may be used as an alternative to DSC when contrast medium is contraindicated or when intravenous injection is not feasible.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>1.</p>\n </section>\n \n <section>\n \n <h3> Technical Efficacy</h3>\n \n <p>Stage 2.</p>\n </section>\n </div>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":"61 2","pages":"758-768"},"PeriodicalIF":3.3000,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Differentiation Between High-Grade Glioma and Brain Metastasis Using Cerebral Perfusion-Related Parameters (Cerebral Blood Volume and Cerebral Blood Flow): A Systematic Review and Meta-Analysis of Perfusion-weighted MRI Techniques\",\"authors\":\"Sana Mohammadi MD, Sadegh Ghaderi PhD, Ali Fathi Jouzdani MD, Iman Azinkhah MSc, Sanaz Alibabaei MSc, Mobin Azami MD, Vida Omrani MSc\",\"doi\":\"10.1002/jmri.29473\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Distinguishing high-grade gliomas (HGGs) from brain metastases (BMs) using perfusion-weighted imaging (PWI) remains challenging. PWI offers quantitative measurements of cerebral blood flow (CBF) and cerebral blood volume (CBV), but optimal PWI parameters for differentiation are unclear.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>To compare CBF and CBV derived from PWIs in HGGs and BMs, and to identify the most effective PWI parameters and techniques for differentiation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Study Type</h3>\\n \\n <p>Systematic review and meta-analysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Population</h3>\\n \\n <p>Twenty-four studies compared CBF and CBV between HGGs (<i>n</i> = 704) and BMs (<i>n</i> = 488).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Field Strength/Sequence</h3>\\n \\n <p>Arterial spin labeling (ASL), dynamic susceptibility contrast (DSC), dynamic contrast-enhanced (DCE), and dynamic susceptibility contrast-enhanced (DSCE) sequences at 1.5 T and 3.0 T.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Assessment</h3>\\n \\n <p>Following the PRISMA guidelines, four major databases were searched from 2000 to 2024 for studies evaluating CBF or CBV using PWI in HGGs and BMs.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Statistical Tests</h3>\\n \\n <p>Standardized mean difference (SMD) with 95% CIs was used. Risk of bias (ROB) and publication bias were assessed, and <i>I</i><sup>2</sup> statistic was used to assess statistical heterogeneity. A <i>P</i>-value<0.05 was considered significant.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>HGGs showed a significant modest increase in CBF (SMD = 0.37, 95% CI: 0.05–0.69) and CBV (SMD = 0.26, 95% CI: 0.01–0.51) compared with BMs. Subgroup analysis based on region, sequence, ROB, and field strength for CBF (HGGs: 375 and BMs: 222) and CBV (HGGs: 493 and BMs: 378) values were conducted. ASL showed a considerable moderate increase (50% overlapping CI) in CBF for HGGs compared with BMs. However, no significant difference was found between ASL and DSC (<i>P</i> = 0.08).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Data Conclusion</h3>\\n \\n <p>ASL-derived CBF may be more useful than DSC-derived CBF in differentiating HGGs from BMs. This suggests that ASL may be used as an alternative to DSC when contrast medium is contraindicated or when intravenous injection is not feasible.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Level of Evidence</h3>\\n \\n <p>1.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Technical Efficacy</h3>\\n \\n <p>Stage 2.</p>\\n </section>\\n </div>\",\"PeriodicalId\":16140,\"journal\":{\"name\":\"Journal of Magnetic Resonance Imaging\",\"volume\":\"61 2\",\"pages\":\"758-768\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2024-06-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Magnetic Resonance Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/jmri.29473\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jmri.29473","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Differentiation Between High-Grade Glioma and Brain Metastasis Using Cerebral Perfusion-Related Parameters (Cerebral Blood Volume and Cerebral Blood Flow): A Systematic Review and Meta-Analysis of Perfusion-weighted MRI Techniques
Background
Distinguishing high-grade gliomas (HGGs) from brain metastases (BMs) using perfusion-weighted imaging (PWI) remains challenging. PWI offers quantitative measurements of cerebral blood flow (CBF) and cerebral blood volume (CBV), but optimal PWI parameters for differentiation are unclear.
Purpose
To compare CBF and CBV derived from PWIs in HGGs and BMs, and to identify the most effective PWI parameters and techniques for differentiation.
Study Type
Systematic review and meta-analysis.
Population
Twenty-four studies compared CBF and CBV between HGGs (n = 704) and BMs (n = 488).
Field Strength/Sequence
Arterial spin labeling (ASL), dynamic susceptibility contrast (DSC), dynamic contrast-enhanced (DCE), and dynamic susceptibility contrast-enhanced (DSCE) sequences at 1.5 T and 3.0 T.
Assessment
Following the PRISMA guidelines, four major databases were searched from 2000 to 2024 for studies evaluating CBF or CBV using PWI in HGGs and BMs.
Statistical Tests
Standardized mean difference (SMD) with 95% CIs was used. Risk of bias (ROB) and publication bias were assessed, and I2 statistic was used to assess statistical heterogeneity. A P-value<0.05 was considered significant.
Results
HGGs showed a significant modest increase in CBF (SMD = 0.37, 95% CI: 0.05–0.69) and CBV (SMD = 0.26, 95% CI: 0.01–0.51) compared with BMs. Subgroup analysis based on region, sequence, ROB, and field strength for CBF (HGGs: 375 and BMs: 222) and CBV (HGGs: 493 and BMs: 378) values were conducted. ASL showed a considerable moderate increase (50% overlapping CI) in CBF for HGGs compared with BMs. However, no significant difference was found between ASL and DSC (P = 0.08).
Data Conclusion
ASL-derived CBF may be more useful than DSC-derived CBF in differentiating HGGs from BMs. This suggests that ASL may be used as an alternative to DSC when contrast medium is contraindicated or when intravenous injection is not feasible.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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