Dynamics of contrast enhancement in delayed computed tomography of brain tumors: tissue-blood ratio and differential diagnosis.

Thirty-one patients with brain tumors were studied by delayed computed tomographic (CT) scanning performed one and two hours after intravenous administration of contrast medium. Dynamics of contrast enhancement in the lesion were analyzed quantitatively and qualitatively by calculating the tissue-blood ratio (TBR) at each scan, and are expressed as relative TBR (R-TBR). The R-TBRs obtained two hours after the first contrast-enhanced scan were found to be most useful in diagnosis, and were classified into three groups: less than 1.5 (Class I), 1.5 to 3.0 (Class II), and more than 3.0 (Class III). In the glioma group, seven of eight anaplastic gliomas were Class III and all of three anaplastic astrocytomas were Class II. All of seven meningiomas were Class I. Four of five pituitary adenomas were Class II. Three of four neurinomas were Class III. This method is potentially useful in differential diagnosis of some brain tumors.