Detectability of Intraaxial Lesions and Disseminations for Primary Malignant Brain Tumors using Three-Dimensional Contrast-Enhanced Multisection Motion Sensitized Driven Equilibrium

Introduction: Multisection motion sensitized driven equilibrium (MSDE) can completely suppress any flow signal and uses gadolinium-based contrast medium. Therefore, 3-dimensional MSDE with contrast medium (3D-CE-MSDE) can visualize only abnormal enhancements. Our purpose is to determine the usefulness of 3D-CE-MSDE for primary malignant brain tumors.

Method: We used a 3.0 Tesla MRI unit. The subjects were 29 consecutive patients with primary malignant brain tumors, including patients with recurrent cancer (mean age: 56.2 ± 25.2 years; 13 men and 16 women). Both 3-dimensional T1 turbo field echo with the contrast medium (3D-CE-T1TFE) and 3D-CE-MSDE were performed as preoperative studies on the same day. We calculated the contrastto- noise ratio (CNR) for each sequence. Two radiologists (A, B) independently evaluated the number of enhanced intraaxial and disseminated lesions observed in each sequence. We statistically analyzed the results using a paired t-test.

Result: The 3D-CE-MSDE CNR was significantly higher than that of 3D-CE-T1TFE (p < 0.01). Radiologist A found that 3D-CE-MSDE was superior to 3D-CE-T1TFE in detecting both intraaxial lesions and disseminations (p=0.04 and p<0.01, respectively). Radiologist B found that 3D-CE-MSDE was superior to 3D-CE-T1TFE in detecting intraaxial lesions (p=0.01). For disseminated lesions, no significant difference in detectability was observed (p=0.097).

Conclusion: In primary malignant brain tumors, 3D-CE-MSDE is useful for detecting enhanced lesions because it completely suppresses flow signals and high CNR.

Author(s):

Masafumi Kanoto, Kazukuni Kirii, Takaaki Hosoya, Toshitada Hiraka, Yuuki Toyoguchi, Megumi Kuchiki, Yukio Sugai, Makoto Obara

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