Summary
Knowledge of the natural history of contrast enhancement after brain tumour resection may help improve postoperative imaging. In a prospective study 42 patients with glioblastomas were evaluated by both CT and MRI before and — at specific intervals — after surgery. Up to the 4th postoperative day areas of enhancement, always better shown by MIR, reflected residual tumour. During the 2nd postoperative week new enhancement occurred along the resection lines. However, increasing protein concentration plus methaemoglobin formation within the resection defect resulted in Tl shortening and made even MRI difficult to interpret. We recommend that postoperative imaging to assess residual enhancing tumour should be performed within the first 4 days after surgery, preferably by MRI. Such a timing minimizes “benign” enhancement due to the surgical trauma. Follow-up of our patients may reveal how the extent of surgical resection influences survival rates.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bird RC, Drayer BP, Medina M, Rekate HL, Flom RA, Hodak JA (1988) Gd-DPTA- enhanced MR imaging in pediatric patients after brain tumor resection. Radiology 169:123–126
Cairncross JG, Pexman JHW, Rathbone MP, DelMaestro RF (1985) Postoperative contrast enhancement in patients with brain tumor. Ann Neurol 17:570–572
Earnest F, Kelly PJ, Scheithauer BW, Kall BA, Cascino TL, Ehman RL, Forbes GS, Axley PL (1988) Cerebral astrocytomas: histopathologic correlation of MR and CT contrast enhancement with stereotactic biopsy Radiology 166:823–827
Elster AD, DiPersio DA (1990) Cranial postoperative site: assessment with contrast-enhanced MR imaging. Radiology 174: 93–98
Jeffries BF, Kishore PRS, Singh KS, Ghatak NR, Krempa J (1980) Postoperative computed tomographic changes in brain: an experimental study. Radiology 135:751–753
Jeffries BF, Kishore PRS, Singh KS, Ghatak NR, Krempa J (1981) Contrast enhancement in the postoperative brain. Radiology 139:409–413
Johnson PC, Hunt SJ, Drayer BP (1989) Human cerebral gliomas: correlation of postmortem MR imaging and neuropathology findings. Radiology 170: 211–217
Mahaley MS, Mettlin C, Nachimuthu N, Laws ER (1990) Analysis of patterns of care of brain tumor patients in the United States: a study of the brain tumor section of the American Association of Neurological Surgeons and the CNS and Commission on Cancer of the American College of Surgeons. Clin Neurosurg 36:347–357
Penn RD, Walser R, Kurtz D (1976) Tumor volume, luxury perfusion, and regional blood volume changes in man visualized by subtraction computed tomography. J Neurosurg 44:449–457
Runge VM, Clanton JA, Price AC (1985) Evaluation of contrast enhanced MR imaging in a brain-abscess model. AJNR 6: 137–147
Zagzag D, Goldenberg M, Brem S (1989) Angiogenesis and biood-brain barrier breakdown modulate CT contrast enhancement: an experimental study in a rabbit brain-tumor model. AJNR 10: 529–534
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1991 Springer-Verlag
About this paper
Cite this paper
Forsting, M., Albert, F.K., Sartor, K., Kunze, S. (1991). Early postoperative CT and MRI in glioblastoma. In: du Boulay, G., Molyneux, A., Moseley, I. (eds) Proceedings of the XIV Symposium Neuroradiologicum. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-49329-4_8
Download citation
DOI: https://doi.org/10.1007/978-3-642-49329-4_8
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-49331-7
Online ISBN: 978-3-642-49329-4
eBook Packages: Springer Book Archive