A reinvestigation of maximal signal drop in dynamic susceptibility contrast magnetic resonance imaging

Background and Purpose. The purpose of this study was to reevaluate the usefulness of relative maximum signal drop (rMSD), as compared to relative cerebral blood volume (rCBV) and cerebral blood flow (rCBF), in dynamic susceptibility contrast magnetic resonance imaging (MRI). Methods. Twenty-five patients (11 with cerebral gliomas and 14 with infarcts of middle cerebral arterial territories) were included. The rMSD values were measured from 83 regions of interest and compared with measurements from corresponding rCBV and rCBF maps. Results. In stroke patients, rMSD correlated strongly with rCBF (r = 0.96) but only fairly with rCBV (r = 0.69). The absence of an association between rMSD and rCBV was evident in regions of increased contrast bolus dispersion. In glioma patients, the correlation of rMSD with rCBF (r = 0.85) was similar to that of rMSD with rCBV (r = 0.80). The interparameter associations were well predicted by computer simulations. Conclusions. The authors conclude that rMSD is as useful as rCBF under a variety of pathophysiological conditions, whereas in conditions with normal mean transit time, such as brain tumors, rMSD provides equivalent blood volume information to rCBV. The simplicity of rMSD maps could lead to the increased use of perfusion-weighted MRI.