Enhancement degree of brain metastases: correlation analysis between enhanced T2 FLAIR and vascular permeability parameters of dynamic contrast-enhanced MRI

Teng Jin; Hua Zhang; Xiaoming Liu; Xiangchuang Kong; Joyman Makamure; Ziwen Chen; Osamah Alwalid; Zhenwei Yao; Jing Wang

doi:10.1007/s00330-020-07625-8

Enhancement degree of brain metastases: correlation analysis between enhanced T2 FLAIR and vascular permeability parameters of dynamic contrast-enhanced MRI

Eur Radiol. 2021 Aug;31(8):5595-5604. doi: 10.1007/s00330-020-07625-8. Epub 2021 Apr 13.

Authors

Teng Jin^#¹, Hua Zhang^#², Xiaoming Liu¹, Xiangchuang Kong¹, Joyman Makamure¹, Ziwen Chen³, Osamah Alwalid¹, Zhenwei Yao⁴, Jing Wang⁵

Affiliations

¹ Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
² Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
³ Department of General Surgery, the Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China.
⁴ Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China. zwyao@fudan.edu.cn.
⁵ Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. jjwinflower@126.com.

^# Contributed equally.

PMID: 33847812
DOI: 10.1007/s00330-020-07625-8

Abstract

Objectives: To investigate the correlation between enhancement degrees of brain metastases on contrast-enhanced T2-fluid-attenuated inversion recovery (CE-T2 FLAIR) and vascular permeability parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

Methods: Thirty-nine patients with brain metastases were prospectively collected. They underwent non-enhanced T2 FLAIR, DCE-MRI, CE-T2 FLAIR, and contrast-enhanced three-dimensional brain volume imaging (CE-BRAVO). Quantitative parameters of DCE-MRI were evaluated for all lesions, which included volume transfer constant (K^trans), rate constant (K_ep), and fractional volume of the extracellular extravascular space (V_e). Contrast ratio (CR) and percentage increase (PI) values of all lesions on CE-T2 FLAIR were also measured. The tumor enhancement degree on CE-T2 FLAIR in relation to CE-BRAVO was visually classified as higher (group A), equal (group B), and lower (group C).

Results: A total of 82 brain metastases were evaluated, including 31 in group A, 19 in group B, and 32 in group C. The K^trans and K_ep were negatively correlated with the CR (ρ = - 0.551, p < 0.001 and ρ = - 0.708, p < 0.001, respectively) and PI (ρ = - 0.511, p < 0.001 and ρ = - 0.621, p < 0.001, respectively). The K^trans and K_ep of group A were significantly lower than those of group C (both p < 0.001). No significant difference was found in V_e among the groups (p = 0.327).

Conclusions: The enhancement degree of brain metastases on CE-T2 FLAIR is negatively correlated with K^trans and K_ep values, which indicate that vascular permeability parameters may play an important role in explaining the difference in enhancement between CE-T2 FLAIR and CE-BRAVO.

Key points: • The enhancement degree on CE-T2 FLAIR was negatively correlated with K^trans and K_ep values. • The vascular permeability of brain metastasis accounted for the difference in enhancement degree between CE-T2 FLAIR and CE-BRAVO. • CE-T2 FLAIR is useful for detecting brain metastases with mild disruption of the blood-brain barrier.

Keywords: Brain; Magnetic resonance imaging; Malignant neoplasms; Perfusion.

MeSH terms

Brain Neoplasms* / diagnostic imaging
Capillary Permeability*
Contrast Media
Humans
Magnetic Resonance Imaging

Substances

Contrast Media