Role of perfusion weighted imaging in the differential diagnosis of intracranial space occupying lesions

Abstract

Introduction. Magnetic Resonance Imaging (MRI) is a well-established modality for identifying intracranial space-occupying lesions (ICSOLs). However, conventional MRI has limitations in the cerebral glioma accurate grading. Advanced techniques, like Diffusion-Weighted Imaging (DWI), Perfusion MRI, and Magnetic Resonance Spectroscopic Imaging (MRS), have been introduced to address these limitations. Aims and objective. The primary objective of this research is to assess the significance of perfusion-weighted imaging (PWI) in distinguishing intracranial space-occupying lesions (ICSOLs), with a specific emphasis on its capacity to refine diagnostic accuracy and advance the classification of cerebral gliomas. Materials and methods. A prospective observational research involving 38 patients having ICSOLs used a Philips Multiva 1.5 Tesla MRI system. The protocol included DWI, ADC (Apparent Diffusion Coefficient) analysis, and perfusion imaging. Results. The study population (n=38) had a diverse age range (22-70 years), with a majority in the 30-40 age group. High grade gliomas constituted 43.2% of all the cases. Significant differences in rCBF, rCBV, and MTT have been observed among HGGs & LGGs. Specific cut-off values were used to predict glioma grades. Discussion. Comparisons with existing studies validated these findings, emphasizing the utility of advanced physiological techniques in enhancing diagnostic precision. Discrepancies with certain studies have highlighted the need for a comprehensive approach to lesion characterization. Conclusion. Intracranial lesion diagnosis, especially for meningiomas, demonstrated comparable efficacy between conventional and advanced techniques. While conventional MRI can differentiate lower-grade from higher-grade gliomas to a limited extent, the combination of advanced physiological approaches significantly improves specificity in tumor categorization.

Keywords

• magnetic resonance imaging
• perfusion
• intracranial space occupying lesions
• radiology