MR灌注加权成像对脑胶质瘤病理分级的临床研究  

Clinical value of perfusion-weighted magnetic resonance imaging in the grading of gliomas

作　　者：邹艳[1] 康庄[1] 赖丽莎[1] 叶滨宾[2] 单鸿[1] 

机构地区：[1]中山大学附属第三医院放射科,广州510630 [2]中山大学附属第一医院放射科,广州510080

出　　处：《中华神经医学杂志》2008年第10期1048-1050,共3页Chinese Journal of Neuromedicine

摘　　要：目的探讨磁共振（MR）灌注加权图像对脑胶质瘤病理分级的临床应用价值。方法选择经病理证实的30例胶质瘤患者人组研究，分为高级和低级两组，其中低级胶质瘤14例（Ⅰ级1例，毛细胞型星形细胞瘤；Ⅱ级13例，星形细胞瘤11例包括1例术后复发，室管膜瘤1例．少突胶质细胞瘤1例）；高级胶质瘤16例（Ⅲ级11例，均为间变性星形细胞瘤，包括1例为术后复发；Ⅳ级5例，胶质母细胞瘤4例，室管膜瘤1例）。行MR灌注加权成像，测量肿瘤实质的局部相对脑血容量（rCBV）、相对平均通过时间（rMTT）、相对最大下降斜率（rMSD）值，进行统计学分析。结果低级胶质瘤的妃BV、rMSD、rMTT值分别为1．99±1．00，1．83±0．78，1．10±0．08，高级胶质瘤的rCBV、rMSD、rMTT值分别为4．95±2．04，3．59±1．13，1．03±0．61。高级与低级胶质瘤的rCBV、rMSD值比较，差异均有统计学意义（P〈0．05）。以低级胶质瘤实质rCBV、rMSD值的上限2．99、2．61作为判断阈值，诊断正确率分别为83.3％、80％。结论rCBV、rMSD值对脑胶质瘤分级的诊断有较高的准确性。Objective To investigate the value of perfusion-weighted magnetic resonance imaging （MRI） in the grading of gliomas. Methods Thirty patients with pathologically confirmed glioma underwent perfusion-weighted MRI. Of the 30 glioma patients, 14 patients had low-grade and 16 had high-grade gliomas. The low-grade glioma patients included 1 with WHO grade Ⅰ glioma （pilocytic astrocytoma） and 13 with WHO grade Ⅱ gliomas; in the WHO grade Ⅱ patients, 11 had astrocytoma including 1 with postoperative recurrence, 1 with ependymoma, and 1 with oligodendroglioma. Of the 16 patients with high-grade gliomas, 11 had WHO grade Ⅲ gliomas identified as anaplastic astrocytoma （including 1 with postoperative recurrence） and 5 had WHO Ⅳ gliomas （including 4 with glioblastoma multiforme and 1 with ependymoma）. The relative cerebral blood volume （rCBV）, rMSD and relative mean transit time （rMTT） were measured and statistically analyzed in these patients. Results The rCBV, rMSD and rMTT were 1.99±1.0, 1.83±0.78, and 1.10±0.08 in the patients with low-grade gliomas, as compared to those in the high-grade glioma patients of 4.95 ±2.04, 3.59±1.13, and 1.03 ±0.61, respectively, showing significant differences in the rCBV and rMSD between the two groups （P〈0.05）. The diagnostic accuracy of rCBV and rMSD was 83.3% and 80% for the gliomas using their upper limits （2.99 and 2.61, respectively） as the diagnostic thresholds. Conclusion The values ofrCBV and rMSD have high accuracy in the grading of brain gliomas.

关 键 词：神经胶质瘤 磁共振成像 灌注加权成像 

分 类 号：R739.4[医药卫生—肿瘤]