Quantitative imaging in medicine and surgery · 2026
Correlation between contrast-enhanced T2 fluid-attenuated inversion recovery enhancement and dynamic contrast-enhanced magnetic resonance imaging permeability in brain metastases.
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Zhang Yu, Bao Han, Ye Junjie, Yang Jiyuan, Lei Yang, Li Junyi, Xie Jia, Li Zongfang
Аннотация
BACKGROUND: Contrast-enhanced T2 fluid-attenuated inversion recovery (CE-T2 FLAIR) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) provide complementary information on lesion enhancement and vascular permeability. This study aimed to assess the correlation between CE-T2 FLAIR enhancement and DCE-MRI-derived permeability parameters in brain metastases.
METHODS: This single-center retrospective study included 43 patients with 80 brain metastases confirmed by pathology or follow-up between January 2018 and July 2024. All patients underwent T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), T2 FLAIR, DCE-MRI, CE-T2 FLAIR, and contrast-enhanced T1WI (CE-T1WI) examinations. Quantitative DCE-MRI parameters were evaluated for all lesions, including the volume transfer constant (Ktrans) and the reverse volume transfer constant (Kep). CE-T2 FLAIR enhancement was assessed using contrast ratio (CR) and percentage increase (PI). Lesions were grouped by enhancement level on CE-T2 FLAIR relative to CE-T1WI: hyperenhancement (Group A), similar enhancement (Group B), and hypoenhancement (Group C). Group differences were assessed using the Kruskal-Wallis test, followed by Bonferroni-adjusted Mann-Whitney U tests for pairwise comparisons; associations between CR/PI and Ktrans/Kep were examined using Spearman's rank correlation.
RESULTS: Groups A, B, and C included 17, 45, and 18 lesions, respectively. Group A showed significantly higher CR and PI and lower Ktrans and Kep compared with Groups B and C (all P<0.05). Group B also demonstrated significantly higher CR and PI and lower permeability values than Group C (P<0.05). Lesions in Groups A and B were significantly smaller than those in Group C (P<0.05). CR was negatively correlated with Ktrans (r=-0.467, P<0.001) and Kep (r=-0.526, P<0.001). PI was negatively correlated with Ktrans (r=-0.658, P<0.001) and Kep (r=-0.716, P<0.001).
CONCLUSIONS: Vascular permeability of brain metastases is a key factor contributing to the differential enhancement observed between CE-T2 FLAIR and CE-T1WI, with CE-T2 FLAIR demonstrating superior sensitivity in detecting metastases with low vascular permeability.
METHODS: This single-center retrospective study included 43 patients with 80 brain metastases confirmed by pathology or follow-up between January 2018 and July 2024. All patients underwent T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), T2 FLAIR, DCE-MRI, CE-T2 FLAIR, and contrast-enhanced T1WI (CE-T1WI) examinations. Quantitative DCE-MRI parameters were evaluated for all lesions, including the volume transfer constant (Ktrans) and the reverse volume transfer constant (Kep). CE-T2 FLAIR enhancement was assessed using contrast ratio (CR) and percentage increase (PI). Lesions were grouped by enhancement level on CE-T2 FLAIR relative to CE-T1WI: hyperenhancement (Group A), similar enhancement (Group B), and hypoenhancement (Group C). Group differences were assessed using the Kruskal-Wallis test, followed by Bonferroni-adjusted Mann-Whitney U tests for pairwise comparisons; associations between CR/PI and Ktrans/Kep were examined using Spearman's rank correlation.
RESULTS: Groups A, B, and C included 17, 45, and 18 lesions, respectively. Group A showed significantly higher CR and PI and lower Ktrans and Kep compared with Groups B and C (all P<0.05). Group B also demonstrated significantly higher CR and PI and lower permeability values than Group C (P<0.05). Lesions in Groups A and B were significantly smaller than those in Group C (P<0.05). CR was negatively correlated with Ktrans (r=-0.467, P<0.001) and Kep (r=-0.526, P<0.001). PI was negatively correlated with Ktrans (r=-0.658, P<0.001) and Kep (r=-0.716, P<0.001).
CONCLUSIONS: Vascular permeability of brain metastases is a key factor contributing to the differential enhancement observed between CE-T2 FLAIR and CE-T1WI, with CE-T2 FLAIR demonstrating superior sensitivity in detecting metastases with low vascular permeability.