MRI of intracranial tumours in adults:oedema-attenuated inversion recovery MR sequence in low-field MRI, diffusion-weighted MRI and BOLD fMRI

Abstract The goal of this study was to explore preoperative evaluation of patients with intracranial tumours using magnetic resonance imaging (MRI) methods: oedema-attenuated inversion recovery (EDAIR) sequence in low-field MRI, and diffusion-weighted imaging (DWI) and resting-state functional MRI (fMRI) in high-field MRI. The aim was also to increase our knowledge about the effects of brain surgery on eloquent brain cortices using new MRI techniques. The total number of patients in these studies was 50 (24 women). Enhancement of the tumour in ten patients after intravenous administration of gadolinium-based contrast agent in low-field MRI was examined with a new sequence, EDAIR, and compared with more conventionally used partial saturation spin echo sequences. EDAIR may facilitate the perception of small enhancing lesions and is valuable in low-field imaging, where T1-based contrast is inferior to high-field imaging. DWI was performed on 25 patients in order to evaluate the potential of this imaging method to assist in differential diagnosis of intracranial tumours. It was shown that apparent diffusion coefficient values of the tumour and peritumoural oedema produced by DWI were different in benign and malignant tumours. Resting-state blood oxygen level-dependent (BOLD) fMRI was performed on eight patients and ten healthy volunteers to examine if functional sensorimotor areas in the brain could be determined without any task-related activations. It was shown that intracranial tumours do not appear to hamper visualization of the sensorimotor area in resting-state BOLD fMRI when independent component analysis is performed, and this method may be used in preoperative imaging when activation studies cannot be performed. Conventional BOLD fMRI with motor and auditory stimuli was used with seven patients as the effect of brain surgery was studied. The results suggest that resection of a tumour with preoperative oedema probably decreases pressure on the brain and makes the functional cortex transiently more easily detectable in BOLD fMRI. In conclusion, the MRI imaging methods used in this study can give valuable additional information about the tumour, specifically for preoperative imaging and planning for surgery