Detectability of Intraaxial Lesions and Disseminations for Primary Malignant Brain Tumors using Three-Dimensional Contrast-Enhanced Multisection Motion Sensitized Driven Equilibrium

Introduction: Multisection motion sensitized driven equilibrium (MSDE) can completely suppress any flow signal and uses gadolinium-based contrast medium. Therefore, 3-dimensional MSDE with contrast medium (3D-CE-MSDE) can visualize only abnormal enhancements. Our purpose is to determine the usefulness of 3D-CE-MSDE for primary malignant brain tumors.

Method: We used a 3.0 Tesla MRI unit. The subjects were 29 consecutive patients with primary malignant brain tumors, including patients with recurrent cancer (mean age: 56.2 ± 25.2 years; 13 men and 16 women). Both 3-dimensional T1 turbo field echo with the contrast medium (3D-CE-T1TFE) and 3D-CE-MSDE were performed as preoperative studies on the same day. We calculated the contrastto- noise ratio (CNR) for each sequence. Two radiologists (A, B) independently evaluated the number of enhanced intraaxial and disseminated lesions observed in each sequence. We statistically analyzed the results using a paired t-test.

Result: The 3D-CE-MSDE CNR was significantly higher than that of 3D-CE-T1TFE (p < 0.01). Radiologist A found that 3D-CE-MSDE was superior to 3D-CE-T1TFE in detecting both intraaxial lesions and disseminations (p=0.04 and p<0.01, respectively). Radiologist B found that 3D-CE-MSDE was superior to 3D-CE-T1TFE in detecting intraaxial lesions (p=0.01). For disseminated lesions, no significant difference in detectability was observed (p=0.097).

Conclusion: In primary malignant brain tumors, 3D-CE-MSDE is useful for detecting enhanced lesions because it completely suppresses flow signals and high CNR.


Masafumi Kanoto, Kazukuni Kirii, Takaaki Hosoya, Toshitada Hiraka, Yuuki Toyoguchi, Megumi Kuchiki, Yukio Sugai, Makoto Obara

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