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Erschienen in: Journal of Neurology 1/2011

01.01.2011 | Original Communication

Metabolism and regional cerebral blood volume in autoimmune inflammatory demyelinating lesions mimicking malignant gliomas

verfasst von: Stella Blasel, Waltraud Pfeilschifter, Viola Jansen, Klaus Mueller, Friedhelm Zanella, Elke Hattingen

Erschienen in: Journal of Neurology | Ausgabe 1/2011

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Abstract

Dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) and MR spectroscopy are thought to differentiate tumefactive autoimmune inflammatory demyelinating lesions from glial brain tumours. The aim of this work is to evaluate whether regional cerebral blood volume (rCBV), as well as choline (Cho), N-acetyl-aspartate (NAA) and myo-inositol (mIns) concentrations differ between tumefactive lesions and World Health Organization (WHO) grade II–III gliomas. Five patients with single autoimmune inflammatory demyelinating lesions and nine patients with WHO grade II and III gliomas were examined by DSC-MRI and by two-dimensional (2D) 1H MR spectroscopic imaging (1H-MRSI). rCBV values and metabolite concentrations were normalised to the respective values of the contralateral hemisphere. Normalised rCBV in the tumefactive lesions (mean 2.89, range 1.98–6.74) was in the some high level as in gliomas (mean 2.77, range 1.43–6.22). 1H-MRSI revealed increased normalised choline concentrations in five of six examinations of autoimmune lesions (mean 1.4, range 1.06–1.8) and in eight of nine gliomas (mean 1.35, range 0.92–1.73). Tumefactive autoimmune inflammatory demyelinating lesions not only have imaging appearance of gliomas but may also imitate marked increase of rCBV and Cho in WHO grade II–III gliomas.
Literatur
1.
Zurück zum Zitat Canellas AR, Gols AR, Izquierdo JR, Subirana MT, Gairin XM (2007) Idiopathic inflammatory-demyelinating diseases of the central nervous system. Neuroradiology 49:393–409CrossRefPubMed Canellas AR, Gols AR, Izquierdo JR, Subirana MT, Gairin XM (2007) Idiopathic inflammatory-demyelinating diseases of the central nervous system. Neuroradiology 49:393–409CrossRefPubMed
2.
Zurück zum Zitat Lucchinetti C, Bruck W, Parisi J, Scheithauer B, Rodriguez M, Lassmann H (2000) Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination. Ann Neurol 47:707–717CrossRefPubMed Lucchinetti C, Bruck W, Parisi J, Scheithauer B, Rodriguez M, Lassmann H (2000) Heterogeneity of multiple sclerosis lesions: implications for the pathogenesis of demyelination. Ann Neurol 47:707–717CrossRefPubMed
3.
Zurück zum Zitat Zagzag D, Miller DC, Kleinman GM, Abati A, Donnenfeld H, Budzilovich GN (1993) Demyelinating disease versus tumor in surgical neuropathology. Clues to a correct pathological diagnosis. Am J Surg Pathol 17:537–545CrossRefPubMed Zagzag D, Miller DC, Kleinman GM, Abati A, Donnenfeld H, Budzilovich GN (1993) Demyelinating disease versus tumor in surgical neuropathology. Clues to a correct pathological diagnosis. Am J Surg Pathol 17:537–545CrossRefPubMed
4.
Zurück zum Zitat Ge Y, Law M, Johnson G, Herbert J, Babb JS, Mannon LJ, Grossman RI (2005) Dynamic susceptibility contrast perfusion MR imaging of multiple sclerosis lesions: characterizing hemodynamic impairment and inflammatory activity. Am J Neuroradiol 26:1539–1547PubMed Ge Y, Law M, Johnson G, Herbert J, Babb JS, Mannon LJ, Grossman RI (2005) Dynamic susceptibility contrast perfusion MR imaging of multiple sclerosis lesions: characterizing hemodynamic impairment and inflammatory activity. Am J Neuroradiol 26:1539–1547PubMed
5.
Zurück zum Zitat Wuerfel J, Bellmann-Strobl J, Brunecker P, Aktas O, McFarland H, Villringer A, Zipp F (2004) Changes in cerebral perfusion precede plaque formation in multiple sclerosis: a longitudinal perfusion MRI study. Brain 127:111–119CrossRefPubMed Wuerfel J, Bellmann-Strobl J, Brunecker P, Aktas O, McFarland H, Villringer A, Zipp F (2004) Changes in cerebral perfusion precede plaque formation in multiple sclerosis: a longitudinal perfusion MRI study. Brain 127:111–119CrossRefPubMed
6.
Zurück zum Zitat Wakefield AJ, More LJ, Difford J, McLaughlin JE (1994) Immunohistochemical study of vascular injury in acute multiple sclerosis. J Clin Pathol 47:129–133CrossRefPubMed Wakefield AJ, More LJ, Difford J, McLaughlin JE (1994) Immunohistochemical study of vascular injury in acute multiple sclerosis. J Clin Pathol 47:129–133CrossRefPubMed
7.
Zurück zum Zitat Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, Lublin FD, Metz LM, McFarland HF, O’Connor PW, Sandberg-Wollheim M, Thompson AJ, Weinshenker BG, Wolinsky JS (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the “Mcdonald criteria”. Ann Neurol 58:840–846CrossRefPubMed Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, Lublin FD, Metz LM, McFarland HF, O’Connor PW, Sandberg-Wollheim M, Thompson AJ, Weinshenker BG, Wolinsky JS (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the “Mcdonald criteria”. Ann Neurol 58:840–846CrossRefPubMed
8.
Zurück zum Zitat Kleihues P, Cavanee W (2000) World Heath Organization classification of tumours, pathology and genetics of tumours of the nervous system, 3rd edn. IARC Press, Lyon Kleihues P, Cavanee W (2000) World Heath Organization classification of tumours, pathology and genetics of tumours of the nervous system, 3rd edn. IARC Press, Lyon
9.
Zurück zum Zitat Hattingen E, Raab P, Franz K, Zanella FE, Lanfermann H, Pilatus U (2008) Myo-inositol: a marker of reactive astrogliosis in glial tumors? NMR Biomed 21:233–241CrossRefPubMed Hattingen E, Raab P, Franz K, Zanella FE, Lanfermann H, Pilatus U (2008) Myo-inositol: a marker of reactive astrogliosis in glial tumors? NMR Biomed 21:233–241CrossRefPubMed
10.
Zurück zum Zitat Provencher SW (1993) Estimation of metabolite concentrations from localized in vivo proton NMR spectra. Magn Reson Med 30:672–679CrossRefPubMed Provencher SW (1993) Estimation of metabolite concentrations from localized in vivo proton NMR spectra. Magn Reson Med 30:672–679CrossRefPubMed
11.
Zurück zum Zitat Hattingen E, Pilatus U, Franz K, Zanella FE, Lanfermann H (2007) Evaluation of optimal echo time for 1H-spectroscopic imaging of brain tumors at 3 Tesla. J Magn Reson Imaging 26:427–431CrossRefPubMed Hattingen E, Pilatus U, Franz K, Zanella FE, Lanfermann H (2007) Evaluation of optimal echo time for 1H-spectroscopic imaging of brain tumors at 3 Tesla. J Magn Reson Imaging 26:427–431CrossRefPubMed
12.
Zurück zum Zitat Ostergaard L, Weisskoff RM, Chesler DA, Gyldensted C, Rosen BR (1996) High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: mathematical approach and statistical analysis. Magn Reson Med 36:715–725CrossRefPubMed Ostergaard L, Weisskoff RM, Chesler DA, Gyldensted C, Rosen BR (1996) High resolution measurement of cerebral blood flow using intravascular tracer bolus passages. Part I: mathematical approach and statistical analysis. Magn Reson Med 36:715–725CrossRefPubMed
13.
Zurück zum Zitat Sorensen AG, Copen WA, Ostergaard L, Buonanno FS, Gonzalez RG, Rordorf G, Rosen BR, Schwamm LH, Weisskoff RM, Koroshetz WJ (1999) Hyperacute stroke: simultaneous measurement of relative cerebral blood volume, relative cerebral blood flow, and mean tissue transit time. Radiology 210:519–527PubMed Sorensen AG, Copen WA, Ostergaard L, Buonanno FS, Gonzalez RG, Rordorf G, Rosen BR, Schwamm LH, Weisskoff RM, Koroshetz WJ (1999) Hyperacute stroke: simultaneous measurement of relative cerebral blood volume, relative cerebral blood flow, and mean tissue transit time. Radiology 210:519–527PubMed
14.
Zurück zum Zitat Cha S, Knopp EA, Johnson G, Wetzel SG, Litt AW, Zagzag D (2002) Intracranial mass lesions: dynamic contrast-enhanced susceptibility-weighted echo-planar perfusion MR imaging. Radiology 223:11–29CrossRefPubMed Cha S, Knopp EA, Johnson G, Wetzel SG, Litt AW, Zagzag D (2002) Intracranial mass lesions: dynamic contrast-enhanced susceptibility-weighted echo-planar perfusion MR imaging. Radiology 223:11–29CrossRefPubMed
15.
Zurück zum Zitat Sugahara T, Korogi Y, Kochi M, Ikushima I, Hirai T, Okuda T, Shigematsu Y, Liang L, Ge Y, Ushio Y, Takahashi M (1998) Correlation of MR imaging-determined cerebral blood volume maps with histologic and angiographic determination of vascularity of gliomas. Am J Roentgenol 171:1479–1486 Sugahara T, Korogi Y, Kochi M, Ikushima I, Hirai T, Okuda T, Shigematsu Y, Liang L, Ge Y, Ushio Y, Takahashi M (1998) Correlation of MR imaging-determined cerebral blood volume maps with histologic and angiographic determination of vascularity of gliomas. Am J Roentgenol 171:1479–1486
16.
Zurück zum Zitat Kirov II, Patil V, Babb JS, Rusinek H, Herbert J, Gonen O (2009) MR spectroscopy indicates diffuse multiple sclerosis activity during remission. J Neurol Neurosurg Psychiatry 80:1330–1336CrossRefPubMed Kirov II, Patil V, Babb JS, Rusinek H, Herbert J, Gonen O (2009) MR spectroscopy indicates diffuse multiple sclerosis activity during remission. J Neurol Neurosurg Psychiatry 80:1330–1336CrossRefPubMed
17.
Zurück zum Zitat Law M, Yang S, Wang H, Babb JS, Johnson G, Cha S, Knopp EA, Zagzag D (2003) Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. Am J Neuroradiol 24:1989–1998PubMed Law M, Yang S, Wang H, Babb JS, Johnson G, Cha S, Knopp EA, Zagzag D (2003) Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging. Am J Neuroradiol 24:1989–1998PubMed
18.
Zurück zum Zitat Kirk J, Plumb J, Mirakhur M, McQuaid S (2003) Tight junctional abnormality in multiple sclerosis white matter affects all calibres of vessel and is associated with blood-brain barrier leakage and active demyelination. J Pathol 201:319–327CrossRefPubMed Kirk J, Plumb J, Mirakhur M, McQuaid S (2003) Tight junctional abnormality in multiple sclerosis white matter affects all calibres of vessel and is associated with blood-brain barrier leakage and active demyelination. J Pathol 201:319–327CrossRefPubMed
19.
Zurück zum Zitat Proescholdt MA, Jacobson S, Tresser N, Oldfield EH, Merrill MJ (2002) Vascular endothelial growth factor is expressed in multiple sclerosis plaques and can induce inflammatory lesions in experimental allergic encephalomyelitis rats. J Neuropathol Exp Neurol 61:914–925PubMed Proescholdt MA, Jacobson S, Tresser N, Oldfield EH, Merrill MJ (2002) Vascular endothelial growth factor is expressed in multiple sclerosis plaques and can induce inflammatory lesions in experimental allergic encephalomyelitis rats. J Neuropathol Exp Neurol 61:914–925PubMed
20.
Zurück zum Zitat Jackson JR, Seed MP, Kircher CH, Willoughby DA, Winkler JD (1997) The codependence of angiogenesis and chronic inflammation. FASEB J 11:457–465PubMed Jackson JR, Seed MP, Kircher CH, Willoughby DA, Winkler JD (1997) The codependence of angiogenesis and chronic inflammation. FASEB J 11:457–465PubMed
21.
Zurück zum Zitat Ludwin S, Henry J, McFarland H (2001) Vascular proliferation and angiogenesis in ms: clinical and pathogenic implications. J Neuropathol Exp Neurol 60:505 Ludwin S, Henry J, McFarland H (2001) Vascular proliferation and angiogenesis in ms: clinical and pathogenic implications. J Neuropathol Exp Neurol 60:505
22.
Zurück zum Zitat Arnold DL, Matthews PM, Francis GS, O’Connor J, Antel JP (1992) Proton magnetic resonance spectroscopic imaging for metabolic characterization of demyelinating plaques. Ann Neurol 31:235–241CrossRefPubMed Arnold DL, Matthews PM, Francis GS, O’Connor J, Antel JP (1992) Proton magnetic resonance spectroscopic imaging for metabolic characterization of demyelinating plaques. Ann Neurol 31:235–241CrossRefPubMed
23.
Zurück zum Zitat Bitsch A, Bruhn H, Vougioukas V, Stringaris A, Lassmann H, Frahm J, Bruck W (1999) Inflammatory CNS demyelination: histopathologic correlation with in vivo quantitative proton MR spectroscopy. Am J Neuroradiol 20:1619–1627PubMed Bitsch A, Bruhn H, Vougioukas V, Stringaris A, Lassmann H, Frahm J, Bruck W (1999) Inflammatory CNS demyelination: histopathologic correlation with in vivo quantitative proton MR spectroscopy. Am J Neuroradiol 20:1619–1627PubMed
24.
Zurück zum Zitat Bruhn H, Frahm J, Gyngell ML, Merboldt KD, Hanicke W, Sauter R, Hamburger C (1989) Noninvasive differentiation of tumors with use of localized H-1 MR spectroscopy in vivo: initial experience in patients with cerebral tumors. Radiology 172:541–548PubMed Bruhn H, Frahm J, Gyngell ML, Merboldt KD, Hanicke W, Sauter R, Hamburger C (1989) Noninvasive differentiation of tumors with use of localized H-1 MR spectroscopy in vivo: initial experience in patients with cerebral tumors. Radiology 172:541–548PubMed
25.
Zurück zum Zitat Tiberio M, Chard DT, Altmann DR, Davies G, Griffin CM, McLean MA, Rashid W, Sastre-Garriga J, Thompson AJ, Miller DH (2006) Metabolite changes in early relapsing-remitting multiple sclerosis. a two year follow-up study. J Neurol 253:224–230CrossRefPubMed Tiberio M, Chard DT, Altmann DR, Davies G, Griffin CM, McLean MA, Rashid W, Sastre-Garriga J, Thompson AJ, Miller DH (2006) Metabolite changes in early relapsing-remitting multiple sclerosis. a two year follow-up study. J Neurol 253:224–230CrossRefPubMed
26.
Zurück zum Zitat Lev MH, Rosen BR (1999) Clinical applications of intracranial perfusion MR imaging. Neuroimaging Clin North Am 9:309–331 Lev MH, Rosen BR (1999) Clinical applications of intracranial perfusion MR imaging. Neuroimaging Clin North Am 9:309–331
27.
Zurück zum Zitat Uematsu H, Maeda M (2006) Double-echo perfusion-weighted MR imaging: basic concepts and application in brain tumors for the assessment of tumor blood volume and vascular permeability. Eur Radiol 16:180–186CrossRefPubMed Uematsu H, Maeda M (2006) Double-echo perfusion-weighted MR imaging: basic concepts and application in brain tumors for the assessment of tumor blood volume and vascular permeability. Eur Radiol 16:180–186CrossRefPubMed
28.
Zurück zum Zitat Law M, Saindane AM, Ge Y, Babb JS, Johnson G, Mannon LJ, Herbert J, Grossman RI (2004) Microvascular abnormality in relapsing-remitting multiple sclerosis: perfusion MR imaging findings in normal-appearing white matter. Radiology 231:645–652CrossRefPubMed Law M, Saindane AM, Ge Y, Babb JS, Johnson G, Mannon LJ, Herbert J, Grossman RI (2004) Microvascular abnormality in relapsing-remitting multiple sclerosis: perfusion MR imaging findings in normal-appearing white matter. Radiology 231:645–652CrossRefPubMed
Metadaten
Titel
Metabolism and regional cerebral blood volume in autoimmune inflammatory demyelinating lesions mimicking malignant gliomas
verfasst von
Stella Blasel
Waltraud Pfeilschifter
Viola Jansen
Klaus Mueller
Friedhelm Zanella
Elke Hattingen
Publikationsdatum
01.01.2011
Verlag
Springer-Verlag
Erschienen in
Journal of Neurology / Ausgabe 1/2011
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-010-5703-4

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