Differentiation of infective from neoplastic brain lesions by dynamic contrast-enhanced MRI

Introduction It is not always possible to differentiate infective from neoplastic brain lesions with conventional MR imaging. In this study, we assessed the utility of various perfusion indices in the differentiation of infective from neoplastic brain lesions. Methods A total of 103 patients with infective brain lesions (group I, n =26) and neoplastic brain lesions (high-grade glioma, HGG, group II, n =52; low-grade glioma, LGG, group III, n =25) underwent dynamic contrast-enhanced MR imaging. The perfusion indices, including relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), transfer coefficient (k trans ) and leakage (v e ), were calculated and their degree of correlation with immunohistologically obtained microvessel density (MVD) and vascular endothelial growth factor (VEGF) determined. The rCBV was corrected for the leakage effect. Discriminant analysis for rCBV, rCBF, k trans and v e was performed to predict the group membership of each case and post hoc analysis was performed to look for group differences. Results The rCBV, rCBF, k trans , v e , MVD and VEGF were significantly different ( P