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Enhancement degree of brain metastases: correlation analysis between enhanced T2 FLAIR and vascular permeability

Teng Jin1, Hua Zhang2, Xiaoming Liu1

  • 1Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

European Radiology
|April 13, 2021
PubMed
Abstract

Insights

Brain metastasis enhancement on contrast-enhanced T2 FLAIR correlates negatively with vascular permeability (Ktrans and Kep). This indicates that blood-brain barrier permeability influences imaging differences, aiding detection of metastases with mild disruption.

Area of Science:

  • Radiology
  • Neuro-oncology
  • Medical Imaging

Background:

  • Brain metastases present a significant challenge in neuro-oncology.
  • Accurate assessment of blood-brain barrier (BBB) integrity is crucial for diagnosing and monitoring brain metastases.
  • Contrast-enhanced T2 fluid-attenuated inversion recovery (CE-T2 FLAIR) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are advanced imaging techniques used to evaluate brain lesions.

Purpose of the Study:

  • To investigate the correlation between the degree of enhancement of brain metastases on CE-T2 FLAIR and vascular permeability parameters derived from DCE-MRI.
  • To understand how vascular permeability influences the observed enhancement patterns in brain metastases on different MRI sequences.

Main Methods:

  • Prospective collection of 39 patients with brain metastases.
  • Acquisition of non-enhanced T2 FLAIR, DCE-MRI, CE-T2 FLAIR, and contrast-enhanced three-dimensional brain volume imaging (CE-BRAVO).
  • Quantitative evaluation of DCE-MRI parameters (Ktrans, Kep, Ve) and CE-T2 FLAIR metrics (CR, PI), with visual classification of enhancement degrees.

Main Results:

  • A total of 82 brain metastases were analyzed.
  • Significant negative correlations were found between Ktrans, Kep and contrast ratio (CR), percentage increase (PI) on CE-T2 FLAIR (p < 0.001).
  • Group with higher CE-T2 FLAIR enhancement (Group A) showed significantly lower Ktrans and Kep values compared to Group C (p < 0.001).

Conclusions:

  • The enhancement degree of brain metastases on CE-T2 FLAIR is inversely related to Ktrans and Kep values.
  • Vascular permeability parameters are key factors explaining the differential enhancement observed between CE-T2 FLAIR and CE-BRAVO.
  • CE-T2 FLAIR is valuable for detecting brain metastases characterized by subtle disruptions of the blood-brain barrier.
Keywords:
BrainMagnetic resonance imagingMalignant neoplasmsPerfusion

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