| Autor: |
MASUDA, Yosuke, ISHIKAWA, Eiichi, YAMAMOTO, Tetsuya, MATSUDA, Masahide, AKUTSU, Hiroyoshi, KOHZUKI, Hidehiro, NAKAI, Kei, OKAMOTO, Emiko, TAKANO, Shingo, MASUMOTO, Tomohiko, MATSUMURA, Akira |
| Jazyk: |
angličtina |
| Rok vydání: |
2016 |
| Zdroj: |
Magnetic resonance in medical sciences. 15(3):299-307 |
| ISSN: |
1347-3182 |
| Popis: |
Background: Carmustine (BCNU) wafer (Gliadel® Wafer) implantation after tumor resection is an approved treatment for high-grade glioma (HGG). These wafers change various characteristics on early postoperative magnetic resonance imaging (ep-MRI) including slight expansion of high-intensity areas on T2-weighted imaging (ep-T2-HIAs) into adjacent parenchyma without restricted diffusivity. We assessed the frequency of the ep-T2-HIAs after BCNU wafer implantation in HGG patients. Moreover, we focused on ep-T2-HIA expansion and its relation to delayed cerebral edema. Methods: Twenty-five consecutive HGG patients who underwent BCNU wafer implantation were assessed. First, patients were divided into ep-T2-HIA and non-ep-T2-HIA groups, and the incidence of delayed adverse effects was compared between the two groups. Subsequently, the patients were divided into delayed edema and non-delayed edema groups, and pre-, intra-, and postoperative data were compared between the two groups. Results: The ep-T2-HIA expansion and the delayed edema were evident in 9 cases (36%) and 12 cases (48%), respectively. In comparison of the ep-T2-HIA and non-ep-T2-HIA groups, delayed edema was the only delayed adverse effect associated with ep-T2-HIA expansion (P = 0.004). Univariate analysis showed a significantly higher ratio of delayed edema in the subgroups with maximal diameter of removed cavity ≤40 mm (P = 0.047) and the ep-T2-HIA expansion in comparison of the delayed edema and non-delayed edema groups. Multivariate analysis showed that the ep-T2-HIA expansion was the only independent factor associated with delayed edema (P = 0.021). Conclusion: In BCNU wafer implantation cases, ep-T2-HIA expansion was a predictive factor for delayed cerebral edema. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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