高分辨DWI在检测颅底肿瘤及术后复发或残留的价值研究  

The Study of High Resolution DWI in the Detection of Brain Lesions at the Skull Base and Recurrence or Residual Lesions after Surgery

作　　者：赵美华 杨广庆 乔瑞华[2] 魏小二[2] 

机构地区：[1]浦东新区光明中医医院放射科 [2]上海交通大学附属第六人民医院放射科

出　　处：《中国医学计算机成像杂志》2014年第6期485-490,共6页Chinese Computed Medical Imaging

基　　金：国家自然科学基金No.81301213~~

摘　　要：目的:探讨高分辨DWI技术在检测颅底肿瘤以及脑肿瘤术后复发或残留病灶中的价值。方法:回顾性分析同时行高分辨和常规DWI扫描的颅底肿瘤以及脑肿瘤术后残留或复发患者的MRI以及CT资料。以MRI所有序列上发现的病灶数目为参考标准,首先比较高分辨DWI和常规DWI在发现病灶能力上的差异,再进一步评价二者之间图像质量的差异。结果:72例术前颅底肿瘤患者81个颅底病灶和45例脑肿瘤术后复发或残留患者51个病灶纳入到最后的分析中。对于术前位于颅底的肿瘤患者,与常规DWI(检测出63个病灶)相比,高分辨DWI能够发现更多的病灶(检测出全部81个病灶)(P<0.001),然而,这种差异主要是体现在发现颅前窝病灶的能力上(P<0.001),而在颅中窝和颅后窝时则无明显统计学差异(P>0.05)。此外,高分辨DWI的图像质量要优于常规DWI图像(P<0.01)。对于术后复发患者,与常规DWI相比,高分辨DWI能够发现更多的病灶(P<0.001)。此外,术后复发患者高分辨DWI的图像质量要优于常规DWI图像(P<0.01)。结论:使用分段读取EPI联合并行采集、二维导航校正的高分辨DWI能够检测出更多的病灶、获得高质量的图像,可作为脑肿瘤及术后患者重要的辅助诊断工具。Purpose： To analyze the value of high resolution DWI in the detection of brain lesions at the skull base and recurrence or residual lesions after surgery. Methods： The MRI and CT images of patients with brain tumor located at the skull base and with recurrence or residual lesion after brain tumor surgery were retrospectively analyzed. All these patients were performed both high resolution DWI and conventional DWI. The total number of lesions and the number of lesions at different sites on all MRI sequences were used as reference measures. Then differences in detecting lesions and image quality between high resolution DWI and conventional DWI were analyzed. Results： A total of 72 patients with 81 lesions located at the skull base and 45 patients with 51 recurrence or residual lesions after brain tumor surgery were included in the final analysis. Compared to conventional DWI, high resolution DWI could detect more lesions located at the skull base （P〈0.001）. However, this difference was mainly due to an improved ability of high resolution DWI to detect lesions located in the anterior cranial fossa （P〈0.001）. For image quality, high resolution DWI was significantly better than conventional DWI images （P〈0.01）. For patients with brain tumor surgery, high resolution DW! could detect more recurrence or residual lesions （P〈0.001）. In addition, image quality of high resolution DWI was significantly better than conventional DWI images for these postoperative patients （P〈0.01）. Conclusion： The high resolution DWI technique is a useful tool for the detection and evaluation of lesions located at the skull base or recurrence or residual lesions after surgery.

关 键 词：颅底 脑肿瘤 手术 弥散加权成像 分段读取平面回波序列 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]