» Articles » PMID: 20195675

The Striate Sign: Peritumoural Perfusion Pattern of Infiltrative Primary and Recurrent Gliomas

Overview
Journal Neurosurg Rev
Specialty Neurosurgery
Date 2010 Mar 3
PMID 20195675
Citations 4
Authors
Affiliations
Soon will be listed here.
Abstract

MR perfusion depicts angiogenesis as a key factor for growth and malignancy in gliomas by means of increased regional cerebral blood volume (rCBV). The rCBV increase is not limited to the tumour area, but may also produce a stripe-like pattern of peritumoural rCBV increase that we defined as the "striate sign". We evaluated if prior radiochemotherapy influences perfusion values and pattern in and adjacent to malignant gliomas comparing rCBV of treated recurrent gliomas with untreated gliomas. Ninety-three patients with primary or recurrent WHO grades II-IV glial tumours underwent T2*-weighted dynamic susceptibility-weighted contrast-enhanced (DSC)-MRI. Differences of normalised rCBV and rCBV(max) were evaluated using Kruskal-Wallis analysis with post hoc tests. The number of cases showing a hot spot of rCBV (rCBV(max)) and/or a peritumoural striate pattern of rCBV increase (striate sign) was assessed and evaluated by Fisher's exact test. Significance level was determined as p < 0.05. Normalised rCBV, rCBV(max) and number of cases with the striate sign were significantly lower in recurrent (rCBV = 3.24 +/- 1.22, rCBV(max) = 5.05 +/- 2.27 and striate sign = 10/24) compared to primary WHO grade IV tumours (rCBV = 4.44 +/- 1.39, rCBV(max) = 7.31 +/- 3.0 and striate sign = 17/21, respectively). There were fewer cases with a striate sign in treated recurrent WHO grade III tumours than in untreated malignant transformed WHO grade II tumours. The pattern and degree of rCBV increase in and around gliomas differ between untreated and previously treated tumours. These differences might be due to post-therapeutic changes of the tumour-associated microvasculature by radiochemotherapy. Spectroscopic and susceptibility-weighted MR imaging may provide further insights into the tumour biology.

Citing Articles

Differentiating Glioblastomas from Solitary Brain Metastases: An Update on the Current Literature of Advanced Imaging Modalities.

Fordham A, Hacherl C, Patel N, Jones K, Myers B, Abraham M Cancers (Basel). 2021; 13(12).

PMID: 34199151 PMC: 8231515. DOI: 10.3390/cancers13122960.


Contrast enhancing spots as a new pattern of late onset pseudoprogression in glioma patients.

Voss M, Franz K, Steinbach J, Fokas E, Forster M, Filipski K J Neurooncol. 2019; 142(1):161-169.

PMID: 30604393 DOI: 10.1007/s11060-018-03076-w.


Quantitative T1-mapping detects cloudy-enhancing tumor compartments predicting outcome of patients with glioblastoma.

Muller A, Jurcoane A, Kebir S, Ditter P, Schrader F, Herrlinger U Cancer Med. 2016; 6(1):89-99.

PMID: 27891815 PMC: 5269700. DOI: 10.1002/cam4.966.


Facing contrast-enhancing gliomas: perfusion MRI in grade III and grade IV gliomas according to tumor area.

Di Stefano A, Bergsland N, Berzero G, Farina L, Rognone E, Gastaldi M Biomed Res Int. 2014; 2014:154350.

PMID: 24800207 PMC: 3996293. DOI: 10.1155/2014/154350.

References
1.
Rutten E, Doesburg W, Slooff J . Histologic factors in the grading and prognosis of astrocytoma grade I-IV. J Neurooncol. 1992; 13(3):223-30. DOI: 10.1007/BF00172474. View

2.
Kang T, Kim S, Byun H, Jeon P, Kim K, Kim H . Morphological and functional MRI, MRS, perfusion and diffusion changes after radiosurgery of brain metastasis. Eur J Radiol. 2008; 72(3):370-80. DOI: 10.1016/j.ejrad.2008.08.009. View

3.
OConnor M, Mayberg M . Effects of radiation on cerebral vasculature: a review. Neurosurgery. 2000; 46(1):138-49; discussion 150-1. DOI: 10.1093/neurosurgery/46.1.138. View

4.
Lev M, Ozsunar Y, Henson J, Rasheed A, Barest G, Harsh 4th G . Glial tumor grading and outcome prediction using dynamic spin-echo MR susceptibility mapping compared with conventional contrast-enhanced MR: confounding effect of elevated rCBV of oligodendrogliomas [corrected]. AJNR Am J Neuroradiol. 2004; 25(2):214-21. PMC: 7974605. View

5.
Sugahara T, Korogi Y, Kochi M, Ikushima I, Hirai T, Okuda T . Correlation of MR imaging-determined cerebral blood volume maps with histologic and angiographic determination of vascularity of gliomas. AJR Am J Roentgenol. 1998; 171(6):1479-86. DOI: 10.2214/ajr.171.6.9843274. View