动态对比增强磁共振成像定量分析在术前胶质瘤分级中的临床价值  

Clinical Value of Dynamic Contrast Enhanced Magnetic Resonance Imaging Quantitative Analysis in Preoperative Glioma Grading

作　　者：张艳文[1] 邢伟[1] 卢海涛[1] 邢士军[1] 沈楠[1] ZHANG Yanwen;XING Wei;LU Haitao(Department of Radiology,The Third Affiliated Hospital of Soochow University,Changzhou,Jiangsu Province 213003,P.R.China)

机构地区：[1]苏州大学附属第三医院影像科,常州213001

出　　处：《临床放射学杂志》2020年第10期1926-1930,共5页Journal of Clinical Radiology

基　　金：常州市卫生健康青苗人才培养工程基金项目(CZQM2020032)

摘　　要：目的探讨动态对比增强磁共振成像(DCE-MRI)定量分析对胶质瘤术前分级的临床指导意义和诊断价值。方法回顾性分析经手术病理证实的24例胶质瘤患者资料,其中低级别胶质瘤10例,高级别胶质瘤14例。术前所有患者均行DCE-MRI检查,通过血流动力学Extended Tofts Linear模型对DCE-MRI图像进行血管渗透性定量分析,获取血流动力学参数容积转运常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积比(Ve)、血浆容积分数(Vp),并采用SPSS 25.0进行统计学分析,分别比较各参数在高低级别胶质瘤中是否存在差异。采用受试者工作特征曲线评价上述参数对胶质瘤分级的效能。结果高级别胶质瘤的Ktrans、Kep、Ve值大于低级别胶质瘤,差异具有统计学意义(U值分别为19.000、24.000、32.000,P<0.05)。Ktrans鉴别高、低级别胶质瘤的曲线下面积最大为0.864,Ktrans和Ve敏感性最高为85.71%,Kep特异性最高为90.00%。结论DCE-MRI定量分析参数对术前胶质瘤的分级具有较高的诊断及临床价值。Objective To determine the clinical significance and diagnostic value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)quantitative analysis in preoperative grading of gliomas.Methods Retrospective analysis of 24 cases of glioma confirmed by operation and pathology(10 cases of low-grade glioma and 14 cases of high-grade glioma)was done.DCE-MRI was performed in all patients before operation.The quantitative analysis of vascular permeability in DCE-MRI images was carried out by using hemodynamic Extended Tofts Linear model to obtain the volume transport constant(Ktrans),rate constant(Kep),extracellular space volume ratio(Ve)and plasma volume fraction(Vp).SPSS 25.0 was used for statistical analysis to compare whether there are differences in each parameter in high and low grade gliomas.Evaluation of the efficacy of the above parameters in glioma grading was performed by using the(receiver operation characteristic)ROC curve of the working characteristics of the subjects.Results The value of Ktrans,Kep and Ve of high-grade glioma was higher than that of low-grade glioma,and the difference was statistically significant(U-value was19.000,24.000,32.000,P<0.05).The maximum area under the curve(AUC)was 0.864,the sensitivity of Ktrans and Ve was 85.71%,and the specificity of Ktrans was 90.00%.Conclusion DCE-MRI quantitative parameters have high diagnostic and clinical value for the classification of pre-operative glioma.

关 键 词：胶质瘤 磁共振动态增强 定量 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]