MR灌注成像在鉴别脑胶质瘤放疗后坏死与肿瘤复发中的应用  

The MR Perfusing-weighted Imaging in Differentiating of Necrosis and Recurrence of Glioma after Radiotherapy

作　　者：刘鹏飞[1] 那婧[1] 王晓睿[1] 王媛[1] 戴险峰[1] 

机构地区：[1]黑龙江省哈尔滨医科大学附属第一医院磁共振室,150001

出　　处：《临床放射学杂志》2007年第11期1080-1083,共4页Journal of Clinical Radiology

基　　金：黑龙江省科技攻关项目(编号:GC03C606-3);黑龙江省教育厅科技基金资助项目(编号:11511192)

摘　　要：目的探讨MR灌注成像(PWI)在脑胶质瘤放疗后坏死和肿瘤复发鉴别诊断中的应用。资料与方法对术后行放疗的胶质瘤患者32例(肿瘤复发组18例;放射性坏死组14例),行MRPWI及常规MRI检查。由灌注数据获取脑血容积(CBV)图和脑血流量(CBF)图,计算出病灶及健侧脑皮质最大相对CBV(rCBV)值、最大相对CBF(rCBF)值。结果肿瘤复发组的rCBV值、rCBF值均升高,肿瘤复发的最大rCBV值及最大rCBF值分别为6.23±2.23、5.21±1.55,健侧分别为3.26±1.03(P<0.01)、2.41±1.15(P<0.01);放射性坏死组的rCBV值、rCBF值均降低,最大rCBV值及最大rCBF值分别为1.90±0.53、1.21±0.32,健侧分别为4.26±1.13(P<0.05)、3.36±1.24(P<0.05);两组间最大rCBV值和rCBF值差异均有统计学意义(t检验,P<0.01);非参数相关性分析表明最大rCBV值和最大rCBF值间存在显著的相关性(r=0.795,P<0.05)。结论MRPWI对脑胶质瘤放疗后坏死和肿瘤复发的鉴别有重要意义,最大rCBV值结合最大rCBF值可以更好地鉴别脑胶质瘤放疗后坏死和肿瘤复发。Objective To evaluate MR perfusing weighted imaging in differentiating of necrosis and recurrence of glioma after radiotherapy. Materials and Methods 32 patients with glioma （ 18 cases with recurrence and 14 cases with necrosis） having radiotherapy after surgery had MR perfusion imaging and MR conventional imaging. The color map of CBV and CBF were obtained from perfusion data. The maximal rCBV and rCBF ratios of each lesion and the normal side grey were calculated. Results PWI in 18 cases with recurrence of glioma exhibited increased rCBV and rCBF ratios. The maximal rCBV and rCBF ratios of recurrence of glioma were 6.23 ± 2.23, 5.21 ± 1.55 respectively, each of the mormal side grey were 3.26 ± 1.03 （ P 〈 0. 01 ）, 2.41 ± 1.15 （ P 〈 0. 01 ） respectively; PWI in 14 cases with necrosis after radiotherapy exhibited decreased rCBV and rCBF ratios. The maximal rCBV and rCBF ratios of necrosis of radiotherapy were 1.90 ± 0. 53,1.21 ± 0. 32 respectively, each of the mormal side grey （matter） were 4.26 ± 1.13 （ P 〈 0. 05 ）, 3.36 ± 1. 24 （ P 〈0.05 ） ;The maximal rCBV and rCBF ratios of recurrence of glioma were statistically different from those of necrosis after radiotherapy （P 〈0. 01 ）. There was obvious correlation between the maximal rCBV and rCBF ratios（ r = 0. 795 P 〈 0. 05 ）. Conclusion MR perfusion imaging is useful in differentiating of necrosis and recurrence of glioma after radiotherapy, especially using the maximal rCBF ratio with the maximal rCBV ratio.

关 键 词：胶质瘤 磁共振成像 灌注 复发 坏死 放射性 

分 类 号：R739.4[医药卫生—肿瘤]