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Magnetic resonance diffusion and perfusion for differentiation of low grade from high grade glioma

Radoslav Georgiev, Boyan Balev, Ara Kaprelyan, Marianna Novakova


Gliomas are the most common primary brain tumors with an annual incidence of 5-10 cases per 100,000 in Western populations. They are the leading cause of death among children and adults diagnosed with brain neoplasm. Gliomas are valued at the WHO classification by histopathological grades I to IV. Grades I and II are considered low-grade, while III, IV grades are high grade. Although they are histologically benign tumors most of II grade will transform into malignant grades III and IV in the range of 5-10 years of diagnosis. These grades are important because, they define therapeutic approach and prognosis in patients with gliomas. High grade gliomas were subjected to surgery and / or radiotherapy and / or chemotherapy, have a poor prognosis. Low-grade gliomas have sometimes conservative treatment. Conventional MR images provide important information on the presence of contrast enhancement, oedema, distant tumor foci, hemorrhage, necrosis, mass effect, etc., which are useful in the characterization of tumor aggressiveness and hence tumor grade. Modern techniques such as physiological techniques- MR diffusion and perfusion provide information about tumor physiology as microvascularity, angiogenesis, and cellularity, all of which are also important in determining the tumor grade. MR diffusion technique evaluates the structure of the tumor-cellularity, water content. MR perfusion technique is a marker for capillary density and neovascularisation.


глиоми; степен на глиома; МР дифузия; МР перфузия

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