扩散张量成像在星形细胞瘤术前分级的应用研究  

Application of Diffusion Tensor Imaging on Preoperative Grading of Astrocytoma

作　　者：李少武[1] 田胜勇[1] 李子孝[2] 张迅[3] 戴建平[1] 高培毅[1] 

机构地区：[1]首都医科大学附属北京天坛医院北京市神经外科研究所神经影像中心,北京100050 [2]首都医科大学附属北京天坛医院神经内科,北京100050 [3]西门子(中国)有限公司,北京100000

出　　处：《放射学实践》2007年第3期234-237,共4页Radiologic Practice

摘　　要：目的:探讨扩散张量成像测量水分子扩散状态的参数相对值与星形细胞瘤恶性程度之间的相关性。方法:对43例经组织病理学证实的患者术前均行DTI序列检查。数据经工作站处理生成平均扩散系数(MD)、部分各向异性(FA)图和扩散加权成像(DWI)参数图。计算相对MD值(rMD)和相对FA(rFA)(瘤实体区值/对侧正常白质区值)。采用单因素方差分析LSD检测法分别分析不同星形细胞瘤病理学级别间rMD和rFA值的差异。结果:43例星形细胞瘤患者中:星形细胞瘤(WHOⅡ级)19例,间变性星形细胞瘤(WHOⅢ级)12例和胶质母细胞瘤(WHOⅣ级)12例。WHOⅡ、Ⅲ和Ⅳ级的rMD值分别为1.220±0.227、1.599±0.416和2.264±0.565。统计学检验出现WHOⅡ和Ⅲ级(P<0.001)、Ⅲ和Ⅳ级(P=0.047)、Ⅱ和Ⅳ级(P<0.001)的rMD任意两两组间有显著性差异。WHOⅡ、Ⅲ和Ⅳ级的rFA值分别为0.439±0.120、0.333±0.100和0.268±0.090。统计学检验出现Ⅲ和Ⅳ级(P=0.015)、Ⅱ和Ⅳ级(P<0.001)的rFA任意两两组间有显著性差异。WHOⅡ级与Ⅲ级间rFA值无显著性差异(P=0.88)。结论:DTI测量的rMD和rFA的值术前能区分不同病理级别星形细胞瘤。Objective：To correlatively study the relationship between the water diffusion parameters measured using diffusion tensor imaging （DTI） and the histological malignancy of astrocytoma. Methods ： DTI was pre-operatively performed using a Siemens Trio MR scanner in 43 cases of patients with histologically proven astrocytoma. Mean diffusivity （MD）, fractional anisotropy （FA） and diffusion weighted imaging （DWI） maps were proceeded and created using the workstation of Leonardo Syngo 2004A,Siemens. All the parameter maps were co-registered. The high signal intensity zone demonstrated on the DTI image was regarded as the zone of tumor parenchyma, then, the parameter values （MD, FA and DWI） of ROI in tumor parenchyma and those in the corresponding white matter zone of the contralateral normal hemisphere were individually measured. The relative MD （rMD） and relative FA （rFA） were calculated （parameter value of the tumor/that of the white matter in the contralateral normal hemisphere）. Statistically and pre-operatively, with the use of variance analysis （single factor） and LSD test, the rMD and rFA were individually compared, and, the correlation in the differences of rMD and rFA with different pathological gradings of astrocytoma in reference to the WHO classification criteria was explored. Results：In our collection of 43 cases of astrocytomas, there were 19 cases of astrocytoma （WHO Ⅱ）, 12 cases of anaplastic astrocytoma （WHO Ⅲ） and 12 cases of glioblastoma multiforme （WHO Ⅳ）. The rMD values of WHO Ⅳ（1. 220±0. 227） astrocytoma were significantly lower than those of the WHO Ⅲ（1. 599±0. 416） and WHO Ⅱ（2. 26±0. 565） astrocytomas （P=0. 015 and P〈0. 001 respectively）. The rMD values of the WHO Ⅲ astrocytoma were significantly lower than those of the WHO Ⅱ astrocytoma （P〈0. 001）. The rFA values of the WHO Ⅳ astrocytoma were significantly higher than those of the WHO Ⅲ（0. 333±0. 100） and WHO Ⅱ astrocytomas （0. 268±0. 09

关 键 词：扩散张量成像 星形细胞瘤 恶性 

分 类 号：R739.41[医药卫生—肿瘤]