Pathological factors contributing to crossed cerebellar diaschisis in cerebral gliomas: a study combining perfusion, diffusion, and structural MR imaging
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To investigate imaging features of crossed cerebellar diaschisis (CCD) in cerebral gliomas, and its underlying pathophysiological mechanisms.
Thirty-three pre-surgical patients with cerebral gliomas and 33 healthy controls underwent arterial spin-labeling, diffusion tensor imaging, and high-resolution T1-weighted imaging using MRI, in order to estimate cerebral blood flow (CBF), white matter integrity, and lesion volume, respectively. Asymmetry indices of CBF in the cerebellum were used for evaluating the level of CCD in the patients. These indices were correlated with clinical variables (lesion size and position, tumor histological grade, and CBF asymmetry) and diffusion tensor imaging parameters (fractional anisotropy and number of fibers in the cortico-ponto-cerebellar pathway and across the cerebral hemispheres), respectively.
The patients showed decreased CBF in the cerebellar hemisphere contralateral to the supratentorial tumor, and increased CBF asymmetry in the cerebellum (both P < 0.05). CCD levels in high-grade gliomas were higher than those of low-grade gliomas (P < 0.05). CCD levels were negatively correlated with the size of the supratentorial lesions, and positively correlated with FA asymmetry in the cerebral fibers (both P < 0.05).
CCD in cerebral gliomas was specifically associated with tumor histological grade, lesion size, and white matter impairments in the hemisphere ipsilateral to the tumor. The findings implicated that observing CCD might have potential for assisting grading diagnosis of cerebral gliomas.
KeywordsCrossed cerebellar diaschisis Glioma Magnetic resonance imaging Perfusion imaging Diffusion tensor imaging
crossed cerebellar diaschisis
- 3D ASL
three-dimensional arterial spin labeling
diffusion tensor imaging
cerebral blood flow
Compliance with ethical standards
This study was funded by the Natural Science Foundation of China (Grant no. 81530054), the Chinese Post-Doctor Foundation (2016M603064), the Post-Doctor Foundation Jiangsu province (1501169B), Key Talents Project of Jiangsu Province (Grant nos. ZDRCA2016093), Independent Research Project in State Key Laboratory of Analytical Chemistry for Life Science (Grant nos. 5431ZZXM1716) and the Wellcome Trust (Grant no. 101253/Z/13/Z).
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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