磁共振氨基质子转移成像在神经上皮组织肿瘤分级诊断中的应用  

Amide proton transfer imaging in grading tumors of the neuroepithelial tissue

作　　者：张格[1,2] 王显龙[1] 路世龙[1] 黄凡衡[1] 温志波[1] 

机构地区：[1]南方医科大学珠江医院放射科,广州510282 [2]海南省人民医院放射科

出　　处：《中华神经外科杂志》2013年第10期1005-1008,共4页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金（81171322）;广东省自然科学基金（$2012010009114）;海外联合基金（81128006）

摘　　要：目的评估磁共振氨基质子转移（A胛）成像对神经上皮组织肿瘤分级诊断的临床应用价值。方法对经手术病理证实的33例神经上皮组织肿瘤患者进行常规MRI序列及APT扫描，病灶划分瘤核心区、水肿区及对侧正常脑白质区3个感兴趣区并测量其APT转移率，采用配对t检验分别比较瘤核心区、水肿区及对侧正常白质区的A胛转移率，用两独立样本t检验比较高低级别神经上皮组织肿瘤瘤核心区的APT转移率。结果33例中，Ⅱ级10例，Ⅲ级11例，Ⅳ级12例，将Ⅱ级设为低级别组，Ⅲ级、Ⅳ级为高级别组，高级别组的瘤核心区、水肿区及对侧正常白质区的APT转移率分别为（3．05±0．63）％、（1．94±0．54）％、（1．63±0．46）％，低级别组瘤核心区及对侧正常白质区的APT转移率分别为（1．88±0．54）％、（1．19±0．87）％。无论高级别或低级别神经上皮组织肿瘤，瘤核心区信号均高于水肿区与对侧正常白质区（高级别组P值均〈0．01，低级别组P=0．035〈0．05），且高级别组与低级别组瘤核心区APT转移率的差异具有统计学意义，高级别组瘤核心区信号明显高于低级别组（P〈0．01）。结论APT成像结合常规MRI序列，可提高术前分级诊断的准确率，对神经上皮组织肿瘤分级诊断具有重要的临床价值。Objective To investigate the role of the amide proton transfer （APT） MR sequence in grading tumors of the neuroepithelial tissue, and its application in identifying the different components of the tumors. Methods 33 patients （ 18 male, 15 female, age was from 18 to 71 with mean age of 46 years） were investigated and confirmed to be tumors of neuroepithelial tissue （glioma） by postoperative pathology, in whom 3T MRI with T2-weighted, FLAIR, pre- and post-contrast Tl-weighted and APT sequences were performed. For each patient, APT signal intensities of each regions of interest （ROI） was defined and used for grading. Comparisons of APT signal intensities of high grade were done among tumor core, peritumoral edema and the contralateral normal-appearing white matter （CNAWM） and the APT signal intensities of tumor core were also compared between high and low grade glioma. Results 33 patients included 10 grade Ⅱ tumors, 11 grade Ⅲ tumors, and 12 grade Ⅳ tumors. The average APT signal intensities were significantly higher in the tumor cores both in high and low grade than the peritumoral edema （ P 〈 0.05） and the contralateral normal-appearing white matter （ P 〈 0.01）. Moreover, the APT signal intensities of the tumor cores of high-grade brain tumors were significantly higher than those of low-grade （ P 〈 0. 01 ）. Conclusions Amide proton transfer contrast can differentiate the tumor core from peritumoral edema, and combined with routine MRI is of clinical application value in grading of glioma.

关 键 词：磁共振成像 氨基质子转移 肿瘤 神经上皮 病理学 

分 类 号：R739.4[医药卫生—肿瘤]