Dynamic Features Observation of Contrast-Enhanced MRI in the Different Clinical Stages of Pathologically Confirmed Tumefactive Demyelinating Lesions and Gliomas and Lymphomas

To explore the dynamic evolution rules of tumefactive demyelinating lesions (TDLs) in comparison to Glioma and lymphoma on contrast-enhanced MRI with the different clinical stages, in order to find the new differential imaging features of TDL and brain tumors. 35 TDLs, 35 Gliomas and 35 lymphomas proven by pathological studies were prospectively recruited from 2015 to 2017. Brain contrast-enhanced MRI of different clinical stages including acute phase(≤3 weeks after onset), subacute phase(4–6 weeks after onset) and chronic phase(≥7 weeks after onset) were completed after enrollment. The characteristics of contrast-enhanced MRI in different clinical stages were compared and the evolutional characteristics were summarized. In 35 TDLs, acute phase: the patterns of enhancement mainly patchy (74.3%, n = 26), nodule (34.3%, n = 12), closed ring (14.3%, n = 5) and open ring (11.4%, n = 4), and for subacute phase, were mainly open ring (40.6%, n = 13), closed ring (31.3%, n = 10), patchy (25.0%, n = 8) and irregular edge of enhancement (21.9%, n = 7), and for chronic phase, mainly pale patchy (66.7%, n = 10). In 35 Gliomas and 35 lymphomas, there were no significant different enhancement form in different clinical stages. The manifestation of the TDLs lesions on contrast-enhanced MRI may have dynamics of evolution with different clinical stages. In acute phase, the patterns of enhancement were mainly patchy and nodular. In subacute phase, the enhancement gradually evolved into edge of the lesions. In chronic phase, the degree of enhancement faded evidently which showed mainly pale patchy and even disappeared. The dynamic evolution may help to differentiate TDLs from Glioma and lymphoma.