ldtЛучевая диагностика и терапияDiagnostic radiology and radiotherapy2079-5343Baltic Medical Education Center10.22328/2079-5343-2022-13-2-36-49ldt-727Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL RESEARCHДифференциальная диагностика первичных лимфом центральной нервной системы по данным мультипараметрического МРТ-картированияDifferencial diagnosis of primary central nervous system lymphomas based on multiparametric MRT mappinghttps://orcid.org/0000-0003-3820-2057ТалыбовР. С.TalybovR. S.

 врач-рентгенолог, заведующий отделением

625062, Тюмень, ул. 4км. Червишевского тракта, д.5

 Radiologist, Head

625062, Tyumen, 4km. Chernyshevskiy trakt, St., 5 

rustam230789@gmail.comhttps://orcid.org/0000-0003-4871-2341ТрофимоваТ. Н.TrofimovaT. N.

 доктор медицинских наук, профессор, член-корреспондент РАН; главный научный сотрудник лаборатории нейровизуализации

197376, СанктПетербург, ул. Академика Павлова, д. 9

Dr. of Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, RAS, Chief Scientific Officer of Neuroimaging Laboratory

197376, St. Petersburg, 9, Academician Pavlov St, 

TTrofimova@sogaz-clinic.ruФедеральный центр нейрохирургииРоссияFederal State Budgetary Institution «the Federal Centre of Neurosurgery»Russian FederationИнститут мозга человека имени Н. П. Бехтеревой Российской академии наукРоссияFederal State Budgetary Institution of Science «The Institute of the Human Brain of N.P.BekhterevaRussian Federation2022300620221323649Copyright © Талыбов Р.С., Трофимова Т.Н., 20222022Талыбов Р.С., Трофимова Т.Н.Talybov R.S., Trofimova T.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://radiag.bmoc-spb.ru/jour/article/view/727

ВВЕДЕНИЕ: Первичные лимфомы центральной нервной системы (ПЛЦНС) представляют собой редкую и агрессивную форму экстранодальной неходжкинской лимфомы, которая в большинстве случаев ограничивается головным мозгом. Своевременная диагностика и начало лечения имеют жизненно важное значение. По данным визуализации новообразование характеризуются низким МР сигналом в T1, изоинтенсивным — в T2, выраженным и гомогенным накоплением контрастного вещества и ограничением диффузии.ЦЕЛЬ: Изучить эффективность методики МР-/КТ-перфузии, лежащей в основе мультипараметрического МРТ-картирования, при дифференциальной диагностике первичных лимфом центральной нервной системы в сравнении с низкодифференцированными глиомами (grade 3–4 WHO 2021) и солитарным метастатическим поражением головного мозга.МАТЕРИАЛЫ И МЕТОДЫ: В данное исследование вошли 80 пациентов с впервые выявленными опухолями ЦНС, впоследствии прошедшие обследование/нейрохирургическое лечение в ФГБУ «Федеральный центр нейрохирургии» (Тюмень, Россия) с гистологической верификацией в период с 2018 по 2021 г. В зависимости от гистологического заключения были выделены 4 группы пациентов: 1-я — 33 случая с ПЛЦНС (из которых 10 случаев с не характерными проявлениями по данным перфузионных показателей и 23 случая классических ПЛЦНС), 2-я — с анапластическими астроцитомами — 14 случаев, 3-я — 23 случая с глиобластомами и 4-я — 10 случаев с солитарным метастатическим поражением. Исследование проводили на магнитно-резонансном томографе General Electric Discovery W750 3Т, мультиспиральном рентгеновском компьютерном томографе Canon Aquilion One до и после контрастного усиления.РЕЗУЛЬТАТЫ: В ходе исследования установлено, что МР-/КТ-перфузия имеет ограниченные возможности при диагностике ПЛЦНС. Тем не менее метод обладает рядом неоспоримых преимуществ и является незаменимым в алгоритме комплексного мультипараметрического диагностического подхода для данного типа новообразований.ЗАКЛЮЧЕНИЕ: Возможности нейровизуализации ПЛЦНС, даже с применением усовершенствованных методик сбора МР-/КТ-данных, достаточно ограничены и не всегда позволяют достоверно дифференцировать данную опухоль с другими новообразованиями.

INTRODUCTION: Primary central nervous system lymphoma (PCNSL) represent a rare and aggressive form of extranodal NonHodgkin’s lymphoma, which is in most cases confined to the brain. Prompt diagnosis and starting treatment are vital. According to imaging, the tumor is characterized by low MR signal in T1, isointense in T2, pronounced and homogeneous uptake of contrast agent and restricted diffusion.OBJECTIVE: to study the effectiveness of MR-/CT perfusion techniques, underlying the multiparametric MRT mapping with the differential diagnosis of primary CNS lymphomas in comparison with poorly differentiated gliomas (grade 3–4 WHO 2021) and solitary metastatic brain injury.МATERIALS AND METODS: The study includes 80 patients with newly identified CNS tumors, later having check-up/neurosurgery treatment in Federal Centre of Neurosurgery (Tyumen, Russia) with histological verification within the period from 2018 to 2021. Depending on histological conclusion, 4 groups of patients were identified: 1–33 cases with PCNSL (out of which 10 cases with not typical manifestation based on the data of perfusion parameters and 23 cases of classical PCNSL), 2 — with anaplastic astrocytomas — 14 cases, 3–23 cases with glioblastomas and 4–10 cases with solitary metastatic lesion. The research was held on magnetic resonance tomography General Electric Discovery W750 3Т, multispiral x-ray computer tomography Canon Aquilion One before and after the contrast enhancement.RESULTS: During the study it was established that MR-/CT perfusion is a limited imaging method, possessing ambiguous sensitivity and specificity with PCNSL diagnosis, as they are characterized by not typical manifestation considered as exception. Nevertheless, the method has some undeniable advantages being indispensable in the algorithm of complex multiparametric diagnostic approach for this type of neoplasm.CONCLUSION: The capacity of neuroimaging PCNSL, even applying improved techniques of MR-/CT data collection, is rather limited and it doesn’t always allow to differentiate this tumor with other neoplasms accurately.

нейровизуализацияперфузияпервичная лимфома ЦНСneuroradiologyperfusionPCNSLReferencesHartmann M., Heiland S., Harting I., Tronnier V.M., Sommer C., Ludwig R., Sartor K. Distinguishing of primary cerebral lymphoma from high-grade glioma with perfusion-weighted magnetic resonance imaging // Neurosci Lett. 2003. Vol. 338. P. 119–122. doi: 10.1016/s0304-3940(02)01367-8.Hartmann M., Heiland S., Harting I., Tronnier V.M., Sommer C., Ludwig R., Sartor K. Distinguishing of primary cerebral lymphoma from high-grade glioma with perfusion-weighted magnetic resonance imaging // Neurosci Lett. 2003. Vol. 338. P. 119–122. doi: 10.1016/s0304-3940(02)01367-8.Hakyemez B., Erdogan C., Bolca N., Yildirim N., Gokalp G., Parlak M. Evaluation of different cerebral mass lesions by perfusion-weighed MR imaging // J. Magn. Reson Imaging. 2006. Vol. 24. P. 817–824. doi: /10.1002/jmri.20707.Hakyemez B., Erdogan C., Bolca N., Yildirim N., Gokalp G., Parlak M. Evaluation of different cerebral mass lesions by perfusion-weighed MR imaging // J. Magn. Reson Imaging. 2006. Vol. 24. P. 817–824. doi: /10.1002/jmri.20707.Haldorsen I.S., Krakenes J., Krossnes B.K., Mella O., Espeland A. CT and MR imaging features of primary central nervous system lymphoma in Norway // AJNR Am. J. Neuroradiol. 2009. Vol. 30. P. 744–751. doi: 10.3174/ajnr.A1447.Haldorsen I.S., Krakenes J., Krossnes B.K., Mella O., Espeland A. CT and MR imaging features of primary central nervous system lymphoma in Norway // AJNR Am. J. Neuroradiol. 2009. Vol. 30. P. 744–751. doi: 10.3174/ajnr.A1447.Sugahara T., Korogi Y., Shigematsu Y., Hirai T., Ikushima I., Liang L., Ushio M., Takahashi M. Perfusion sensitive MRI of cerebral lymphomas: a preliminary report // J. Comput Assist. Tomogr. 1999. Vol. 23. P. 232–237. doi: 10.1097/00004728-199903000-00011.Sugahara T., Korogi Y., Shigematsu Y., Hirai T., Ikushima I., Liang L., Ushio M., Takahashi M. Perfusion sensitive MRI of cerebral lymphomas: a preliminary report // J. Comput Assist. Tomogr. 1999. Vol. 23. P. 232–237. doi: 10.1097/00004728-199903000-00011.Rollin N., Guyotat J., Streichenberger N., Honnorat J., Tran Minh V-A., Cotton F. Clinical relevance of diffusion and perfusion magnetic resonance imaging in assessing intra-axial brain tumors // Neuroradiology. 2006. Vol. 48. P. 150–9. doi: 10.1007/s00234-005-0030-7.Rollin N., Guyotat J., Streichenberger N., Honnorat J., Tran Minh V-A., Cotton F. Clinical relevance of diffusion and perfusion magnetic resonance imaging in assessing intra-axial brain tumors // Neuroradiology. 2006. Vol. 48. P. 150–9. doi: 10.1007/s00234-005-0030-7.Lee I.H., Kim S.T., Kim H.J., Kim K.H., Jeon P., Byun H.S. Analysis of perfusion weighted image of CNS lymphoma // Eur. J. Radiol. 2009. Vol. 76. P. 48–51. doi: 10.1371/journal.pone.0173430.Lee I.H., Kim S.T., Kim H.J., Kim K.H., Jeon P., Byun H.S. Analysis of perfusion weighted image of CNS lymphoma // Eur. J. Radiol. 2009. Vol. 76. P. 48–51. doi: 10.1371/journal.pone.0173430.Kremer S., Grand S., Remy C., Esteve F., Lefournier V., Pasquire B., Hoffmann D., Benabid A.L., Le Bas J-F. Cerebral blood volume mapping by MR imaging in the initial evaluation of brain tumors // J. Neuroradiol. 2002. Vol. 29. P. 105–113. doi: 10.2214/AJR.10.5309Kremer S., Grand S., Remy C., Esteve F., Lefournier V., Pasquire B., Hoffmann D., Benabid A.L., Le Bas J-F. Cerebral blood volume mapping by MR imaging in the initial evaluation of brain tumors // J. Neuroradiol. 2002. Vol. 29. P. 105–113. doi: 10.2214/AJR.10.5309Wong E.T. Management of central nervous system lymphomas using monoclonal antibodies: challenges and opportunities // Clin Cancer Res. 2005. Vol. 11. P. 7151–7157. doi: 10.1158/1078–0432.CCR-1004-0002.Wong E.T. Management of central nervous system lymphomas using monoclonal antibodies: challenges and opportunities // Clin Cancer Res. 2005. Vol. 11. P. 7151–7157. doi: 10.1158/1078–0432.CCR-1004-0002.Mohile N.A., Abrey L.E. Primary central nervous system lymphoma // Semin Radiat Oncol. 2007. Vol. 17. P. 223–229. doi: 10.1016/j.ncl.2007.07.00110.Mohile N.A., Abrey L.E. Primary central nervous system lymphoma // Semin Radiat Oncol. 2007. Vol. 17. P. 223–229. doi: 10.1016/j.ncl.2007.07.00110.Koeller K.K., Smirniotopoulos J.G., Jones R.V. Primary central nervous system lymphoma: radiologic-pathologic correlation // Radiographics. 1997. Vol. 17. P. 1497–526. doi: 10.1148/radiographics.17.6.9397461.Koeller K.K., Smirniotopoulos J.G., Jones R.V. Primary central nervous system lymphoma: radiologic-pathologic correlation // Radiographics. 1997. Vol. 17. P. 1497–526. doi: 10.1148/radiographics.17.6.9397461.Iwamoto F.M., Abrey L.E. Primary dural lymphomas: a review // Neurosurg Focus. 2006. Vol. 21, I. 5. doi: 10.3171/foc.2006.21.5.6.Iwamoto F.M., Abrey L.E. Primary dural lymphomas: a review // Neurosurg Focus. 2006. Vol. 21, I. 5. doi: 10.3171/foc.2006.21.5.6.Go J.L., Lee S.C., Kim P.E. Imaging of primary central nervous system lymphoma // Neurosurg Focus. 2006. Vol. 21, E4. doi: 10.3171/foc.2006.21.5.5.Go J.L., Lee S.C., Kim P.E. Imaging of primary central nervous system lymphoma // Neurosurg Focus. 2006. Vol. 21, E4. doi: 10.3171/foc.2006.21.5.5.Senocak E., Oguz K.K., Ozgen B.M., Mut M. Parenchymal lymphoma of the brain on initial MR imaging: a comparative study between primary and secondary brain lymphoma // European J. Radiol. 2010. Vol. 79. P. 288–294. doi: 10.1016/j.ejrad.2010.01.017.Senocak E., Oguz K.K., Ozgen B.M., Mut M. Parenchymal lymphoma of the brain on initial MR imaging: a comparative study between primary and secondary brain lymphoma // European J. Radiol. 2010. Vol. 79. P. 288–294. doi: 10.1016/j.ejrad.2010.01.017.Calli C., Kitis O., Yunten N., Yurtseven T., Islekel S., Akalin T. Perfusion and diffusion MR imaging in enhancing malignant cerebral tumors // European J. Radiol. 2006. Vol. 58. P. 394–403. doi: 10.1016/j.ejrad.2005.12.032.Calli C., Kitis O., Yunten N., Yurtseven T., Islekel S., Akalin T. Perfusion and diffusion MR imaging in enhancing malignant cerebral tumors // European J. Radiol. 2006. Vol. 58. P. 394–403. doi: 10.1016/j.ejrad.2005.12.032.Zacharia T.T., Law M., Naidich T.P., Leeds N.E. Central nervous system lymphoma characterization by diffusion-weighted imaging and MR spectroscopy // J. Neuroimaging. 2008. Vol. 18. P. 411–417. doi: 10.1111/j.1552-6569.2007.00231.x.Zacharia T.T., Law M., Naidich T.P., Leeds N.E. Central nervous system lymphoma characterization by diffusion-weighted imaging and MR spectroscopy // J. Neuroimaging. 2008. Vol. 18. P. 411–417. doi: 10.1111/j.1552-6569.2007.00231.x.Schroeder P.C., Post M.J., Oschatz E., Stadler A., Bruce-Gregorios J., Thurnher M.M. Analysis of the utility of diffusionweighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma // Neuroradiology. 2006. Vol. 48. P. 715–720. doi: 10.1007/s00234-006-0123-y.Schroeder P.C., Post M.J., Oschatz E., Stadler A., Bruce-Gregorios J., Thurnher M.M. Analysis of the utility of diffusionweighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma // Neuroradiology. 2006. Vol. 48. P. 715–720. doi: 10.1007/s00234-006-0123-y.Schlegel U., Schmidt-Wolf I.G., Deckert M. Primary CNS lymphoma: clinical presentation, pathological classification, molecular pathogenesis and treatment // J. Neurol Sci. 2000. Vol. 181. P. 1–12. doi: 10.1016/s0022-510x(00)00385-3.Schlegel U., Schmidt-Wolf I.G., Deckert M. Primary CNS lymphoma: clinical presentation, pathological classification, molecular pathogenesis and treatment // J. Neurol Sci. 2000. Vol. 181. P. 1–12. doi: 10.1016/s0022-510x(00)00385-3.Kuker W., Nagele T., Korfel A., Heckl S., Thiel E., Bamberg M., Weller M., Herrlinger U. Primary central nervous system lymphomas (PCNSL): MRI features at presentation in 100 patients // J. Neurooncol. 2005. Vol. 72. P. 169–177. doi: 10.1007/s11060-004-3390-7.Kuker W., Nagele T., Korfel A., Heckl S., Thiel E., Bamberg M., Weller M., Herrlinger U. Primary central nervous system lymphomas (PCNSL): MRI features at presentation in 100 patients // J. Neurooncol. 2005. Vol. 72. P. 169–177. doi: 10.1007/s11060-004-3390-7.Eichler A.F., Batchelor T.T. Primary central nervous system lymphoma: presentation, diagnosis and staging // Neurosurg Focus. 2006. Vol. 21. E. 15. doi: 10.3171/foc.2006.21.5.16.Eichler A.F., Batchelor T.T. Primary central nervous system lymphoma: presentation, diagnosis and staging // Neurosurg Focus. 2006. Vol. 21. E. 15. doi: 10.3171/foc.2006.21.5.16.Buhring U., Herrlinger U., Krings T. Thiex R., Weller M., Kuker W. MRI features of primary central nervous system lymphomas at presentation // Neurology. 2001. Vol. 57. P. 393–396. doi: 10.1212/wnl.57.3.393.Buhring U., Herrlinger U., Krings T. Thiex R., Weller M., Kuker W. MRI features of primary central nervous system lymphomas at presentation // Neurology. 2001. Vol. 57. P. 393–396. doi: 10.1212/wnl.57.3.393.Coulon A., Lafitte F., Hoang-Xuan K., Martin-Duverneuil N., Mokhtari K., Blustajn J., Chiras J. Radiographic findings in 37 cases of primary CNS lymphoma in immunocompetent patients // Eur. Radiol. 2002. Vol. 12. P. 329–340. doi: 10.1007/s003300101037.Coulon A., Lafitte F., Hoang-Xuan K., Martin-Duverneuil N., Mokhtari K., Blustajn J., Chiras J. Radiographic findings in 37 cases of primary CNS lymphoma in immunocompetent patients // Eur. Radiol. 2002. Vol. 12. P. 329–340. doi: 10.1007/s003300101037.Thurnher M.M., Rieger A., Kleibl-Popov C., Settinek U., Henk C., Haberler C., Schindler E. Primary central nervous system lymphoma in AIDS: a wider spectrum of CT and MRI findings // Neuroradiology. 2001. Vol. 43. P. 29–35. doi: 10.1007/s002340000480.Thurnher M.M., Rieger A., Kleibl-Popov C., Settinek U., Henk C., Haberler C., Schindler E. Primary central nervous system lymphoma in AIDS: a wider spectrum of CT and MRI findings // Neuroradiology. 2001. Vol. 43. P. 29–35. doi: 10.1007/s002340000480.Fine H.A., Mayer R.J. Primary central nervous system lymphoma // Ann. Intern. Med. 1993. Vol. 119. P. 1093–104. doi: 10.7326/0003-4819-119-11-199312010-00007.Fine H.A., Mayer R.J. Primary central nervous system lymphoma // Ann. Intern. Med. 1993. Vol. 119. P. 1093–104. doi: 10.7326/0003-4819-119-11-199312010-00007.Haldorsen I.S., Krakenes J., Goplen A.K., Dunlop O., Mella O., Espeland A. AIDS-related primary central nervous system lymphoma // BMC Cancer. 2008. Vol. 8. P. 225. doi: 10.1186/1471-2407-8-225.Haldorsen I.S., Krakenes J., Goplen A.K., Dunlop O., Mella O., Espeland A. AIDS-related primary central nervous system lymphoma // BMC Cancer. 2008. Vol. 8. P. 225. doi: 10.1186/1471-2407-8-225.Hill Q.A., Owen R.G. CNS prophylaxis in lymphoma: who to target and what therapy to use // Blood Rev. 2006. Vol. 20. P. 319–332. doi: 10.1016/j.blre.2006.02.001.Hill Q.A., Owen R.G. CNS prophylaxis in lymphoma: who to target and what therapy to use // Blood Rev. 2006. Vol. 20. P. 319–332. doi: 10.1016/j.blre.2006.02.001.Bierman P., Giglio P. Diagnosis and treatment of central nervous system involvement in non-Hodgkin’s lymphoma // Hematol Oncol Clin North Am. 2005. Vol. 19. P. 597–609. doi: 10.1016/j.hoc.2005.05.003.Bierman P., Giglio P. Diagnosis and treatment of central nervous system involvement in non-Hodgkin’s lymphoma // Hematol Oncol Clin North Am. 2005. Vol. 19. P. 597–609. doi: 10.1016/j.hoc.2005.05.003.Gleissner B., Chamberlain M. Treatment of CNS dissemination in systemic lymphoma // J. Neurooncol. 2007. Vol. 84. P. 107–117. doi: 10.1007/s11060-007-9353-z.Gleissner B., Chamberlain M. Treatment of CNS dissemination in systemic lymphoma // J. Neurooncol. 2007. Vol. 84. P. 107–117. doi: 10.1007/s11060-007-9353-z.Wu O., Ostergaard L., Sorensen A.G. Technical aspects of perfusion-weighted imaging // Neuroimaging Clin. N. Am. 2005. Vol. 15. P. 623–637. doi: 10.1016/j.nic.2005.08.009.Wu O., Ostergaard L., Sorensen A.G. Technical aspects of perfusion-weighted imaging // Neuroimaging Clin. N. Am. 2005. Vol. 15. P. 623–637. doi: 10.1016/j.nic.2005.08.009.Cianfoni A., Colosimo C., Basile M., Wintermark M., Bonomo L. Brain perfusion CT: principles, technique and clinical applications // Radiol. Med. 2007. Vol. 112, P. 1225–1243. doi: 10.1007/s11547-007-0219-4.Cianfoni A., Colosimo C., Basile M., Wintermark M., Bonomo L. Brain perfusion CT: principles, technique and clinical applications // Radiol. Med. 2007. Vol. 112, P. 1225–1243. doi: 10.1007/s11547-007-0219-4.Fainardi E., Di B.F., Borrelli M., Saletti A., Cavallo M., Sarubbo S., Ceruti S., Tamarozzi R., Chieregato A. Potential role of CT perfusion parameters in the identification of solitary intra-axial brain tumor grading // Acta Neurochir Suppl. 2010. Vol. 106. P. 283–287. doi: 10.1007/978-3-211-98811-4_53.Fainardi E., Di B.F., Borrelli M., Saletti A., Cavallo M., Sarubbo S., Ceruti S., Tamarozzi R., Chieregato A. Potential role of CT perfusion parameters in the identification of solitary intra-axial brain tumor grading // Acta Neurochir Suppl. 2010. Vol. 106. P. 283–287. doi: 10.1007/978-3-211-98811-4_53.Law M., Yang S., Babb J. S., Knopp E.A., Golfinos J.G., Zagrag D., Johnson G. Comparison of cerebral blood volume and vascular permeability from dynamic susceptibility contrast-enhanced perfusion MR imaging with glioma grade // American Journal of Neuroradiology. 2004. Vol. 25, Nо. 5. P. 746–755. PMC7974484.Law M., Yang S., Babb J. S., Knopp E.A., Golfinos J.G., Zagrag D., Johnson G. Comparison of cerebral blood volume and vascular permeability from dynamic susceptibility contrast-enhanced perfusion MR imaging with glioma grade // American Journal of Neuroradiology. 2004. Vol. 25, Nо. 5. P. 746–755. PMC7974484.Takeuchi H., Matsuda K., Kitai R., Sato K., Kubota T. Angiogenesis in primary central nervous system lymphoma (PCNSL) // J. Neurooncol. 2007. Vol. 84, Nо. 2. P. 141–145. doi: 10.1007/s11060-007-9363-x.Takeuchi H., Matsuda K., Kitai R., Sato K., Kubota T. Angiogenesis in primary central nervous system lymphoma (PCNSL) // J. Neurooncol. 2007. Vol. 84, Nо. 2. P. 141–145. doi: 10.1007/s11060-007-9363-x.Wuerfel J., Bellmann-Strobl J., Brunecker P., Aktas O., McFarland H., Villringer A., Zipp F. Changes in cerebral perfusion precede plaque formation in multiple sclerosis: a longitudinal perfusion MRI study // Brain. 2004. Vol. 127. P. 111–119. doi: 10.1093/brain/awh007.Wuerfel J., Bellmann-Strobl J., Brunecker P., Aktas O., McFarland H., Villringer A., Zipp F. Changes in cerebral perfusion precede plaque formation in multiple sclerosis: a longitudinal perfusion MRI study // Brain. 2004. Vol. 127. P. 111–119. doi: 10.1093/brain/awh007.Trofimova T.N., Trofimov E.A. Modern Strategies of Radiation Diagnosis in Primary Brain Tumors. Practical oncology, 2013, Vol. 14, Nо. 3, рр. 141–147 (In Russ.). doi: 10.22328/2079-5343-2015-4-27-34.Trofimova T.N., Trofimov E.A. Modern Strategies of Radiation Diagnosis in Primary Brain Tumors. Practical oncology, 2013, Vol. 14, Nо. 3, рр. 141–147 (In Russ.). doi: 10.22328/2079-5343-2015-4-27-34.Trofimova T.N., Skvortsova T.Yu., Savintseva Zh.I. // Monography cerebral glial tumors radiology. St. Petersburg: publishing house, Foliant 2020. 564 p. (In Russ.). doi: 10.22328/2079-5343-2015-2-54-62.Trofimova T.N., Skvortsova T.Yu., Savintseva Zh.I. // Monography cerebral glial tumors radiology. St. Petersburg: publishing house, Foliant 2020. 564 p. (In Russ.). doi: 10.22328/2079-5343-2015-2-54-62.Lemercier P., Paz Maya S., Patrie J.T., Flors L. Gradient of Apparent Diffusion Coefficient Values in Peritumoral Edema Helps in Differentiation of Glioblastoma From Solitary Metastatic Lesions // AJR. 2014. Vol. 203. P. 163–169. doi: 10.2214/AJR.13.11186.Lemercier P., Paz Maya S., Patrie J.T., Flors L. Gradient of Apparent Diffusion Coefficient Values in Peritumoral Edema Helps in Differentiation of Glioblastoma From Solitary Metastatic Lesions // AJR. 2014. Vol. 203. P. 163–169. doi: 10.2214/AJR.13.11186.Zakaria R., Das K., Radon M., Bhojak M., Rudland P., Sluming V., Jenkinson M. Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes // BMC. 2014. Vol. 14. P. 26. doi: 10.1186/1471-2342-14-26.Zakaria R., Das K., Radon M., Bhojak M., Rudland P., Sluming V., Jenkinson M. Diffusion-weighted MRI characteristics of the cerebral metastasis to brain boundary predicts patient outcomes // BMC. 2014. Vol. 14. P. 26. doi: 10.1186/1471-2342-14-26.Blasel S., Vorwerk R., Kiyose M., Mittelbronn M., Brunnberg U., Ackermann H., Voss M., Harter P., Hattingen E. New MR perfusion features in primary central nervous system lymphomas: pattern and prognostic impact // Journal of Neuro-Oncology. Vol. 131. P. 549–554. doi: 10.1007/s00415-018-8737-7.Blasel S., Vorwerk R., Kiyose M., Mittelbronn M., Brunnberg U., Ackermann H., Voss M., Harter P., Hattingen E. New MR perfusion features in primary central nervous system lymphomas: pattern and prognostic impact // Journal of Neuro-Oncology. Vol. 131. P. 549–554. doi: 10.1007/s00415-018-8737-7.Sugita Y., Takase Y., Mori D., Tokunaga O., Nakashima A., Shigemori M. Endoglin (CD 105) is expressed on endothelial cells in the primary central nervous system lymphomas and correlates with survival // Journal of Neuro-Oncology. Vol. 82. P. 249–256. doi: 10.1007/s11060-006-9281-3.Sugita Y., Takase Y., Mori D., Tokunaga O., Nakashima A., Shigemori M. Endoglin (CD 105) is expressed on endothelial cells in the primary central nervous system lymphomas and correlates with survival // Journal of Neuro-Oncology. Vol. 82. P. 249–256. doi: 10.1007/s11060-006-9281-3.

The authors declare that there are no conflicts of interest present.