颅内肿瘤大剂量Gd-DTPA MR灌注成像的临床应用及安全性  

Application and safty of perfusion-weighted MR imaging with large dose of Gd-DTPA in the diagnosis of intracranial tumors

作　　者：王润文[1] 周高峰[1] 彭仁罗[1] 王小宜[1] 刘凡[1] 贾高志[1] 周勉[1] 聂吉林[1] 

机构地区：[1]中南大学湘雅医院放射科,湖南长沙410008

出　　处：《中国医学影像技术》2008年第4期611-613,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨颅内肿瘤大剂量Gd-DTPA MR灌注成像的应用价值及安全性。方法收集经病理证实的颅内肿瘤36例,其中低级别胶质瘤（Ⅰ-Ⅱ级）15例,高级别胶质瘤（Ⅲ-Ⅳ级）12例,脑膜瘤7例,胆脂瘤1例,脉络丛乳头状瘤1例,使用FID-EPI序列行Gd-DTPA灌注成像。在脑血流容积的伪彩色图像上测得肿瘤的rCBV值,并对各组肿瘤的rCBV值进行统计学t检验;记录注药后患者的表现及不良反应,评价大剂量Gd-DTPA灌注的安全性。结果低级别胶质瘤与高级别胶质瘤的rCBV值,低级别胶质瘤与脑膜瘤的rCBV值比较有统计学意义（P〈0.05）,而高级别胶质瘤与脑膜瘤的rCBV值比较没有统计学意义（P〉0.05）。1例脉络丛乳头状瘤的rCBV值为9.15,表现为高灌注;1例胆脂瘤的rCBV值为0.09,表现为低灌注;36例灌注患者未见药物过敏反应。结论大剂量Gd-DTPA的MR灌注成像有助于脑胶质瘤的分级及与其他颅内肿瘤的鉴别诊断,临床应用的安全性良好。Objective To study the value and safety of perfusion-weighted MR imaging with large dose of Gd-DTPA in the diagnosis of intracranial tumors. Methods MR PWI with FID-EPI sequence was performed in 36 patients with intracranial tumors, including 15 cases of low-grade （grade Ⅰ - Ⅱ ） glioma, 12 cases with high-grade （grade Ⅲ - Ⅳ ） glioma, 7 cases with meningioma, one case with cholesteatoma and one case with choroid plexus papilloma. The tumors rCBV were measured on the pseudo-color images of CBV, which were undertook t test. The salty of PWI with large dose of Gd-DTPA was evaluated by writing down the appearances of patients and adverse reactions of Gd-DTPA. Results The difference of rCBV between low-grade gliomas and high-grade gliomas, meningiomas were statistically significant （P〈0.05）. However, the rCBV between high-grade glimoas and meningiomas showed no statistic difference （P〈0.05）. One choroid plexus papilloma and one cholesteatoma showed hypertransfusion （9.15） and h ypoperfusion （0.09） respectively. No allergic reactions of drug occurred in 36 patients. Condusion PWI with large dose of Gd-DTPA is helpful in grading gliomas and differential diagnosis of intracranial tumors, which is safe in clinic application.

关 键 词：脑肿瘤 磁共振成像 灌注加权成像 对比剂 

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]