Spin-Echo Echo-Planar Perfusion MR Imaging in the Differential Diagnosis of Solitary Enhancing Brain Lesions: Distinguishing Solitary Metastases from Primary Glioma

• Published in: American journal of neuroradiology : AJNR Vol. 30; no. 3; pp. 575 - 577
• Main Authors: Young, G.S, Setayesh, K
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01.03.2009; American Society of Neuroradiology
• Subjects: Adenocarcinoma - secondary; Adult; Aged; Astrocytoma - pathology; Biological and medical sciences; Brain; Brain Neoplasms - pathology; Brain Neoplasms - secondary; Breast Neoplasms - pathology; Carcinoma, Basal Cell - secondary; Colorectal Neoplasms - pathology; Diagnosis, Differential; Echo-Planar Imaging; Esophageal Neoplasms - pathology; Female; Glioblastoma - pathology; Humans; Investigative techniques, diagnostic techniques (general aspects); Lung Neoplasms - pathology; Male; Medical sciences; Melanoma - secondary; Middle Aged; Models, Neurological; Nervous system; Neurology; Prostatic Neoplasms - pathology; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Retrospective Studies; Sarcoma - secondary; Sensitivity and Specificity; Skin Neoplasms - pathology; Vascular diseases and vascular malformations of the nervous system; Nervous system diseases; Glioma; Radiodiagnosis; Perfusion imaging; Central nervous system disease; Central nervous system; Tumor; Spin echo; Nuclear magnetic resonance imaging; Differential diagnostic; Encephalon
• ISSN: 0195-6108; 1936-959X
• DOI: 10.3174/ajnr.A1239

Unlike the more widely reported gradient-echo echo-planar perfusion-weighted imaging (EPI-PWI) technique, spin-echo (SE) EPI relative cerebral blood volume maps select for blood volume in microvessels <8 microm in diameter. This first report of SE-EPI PWI for distinguishing brain metastasis from high-grade glioma demonstrated 88% sensitivity and 72% specificity in 83 patients. We discuss differences in microvessel architecture between high-grade glioma and brain metastasis that may explain the surprising success of SE-EPI in this application and may deserve further investigation.