DSC-MRI和DCE-MRI定量分析在脑胶质瘤分级诊断中的应用  

Dynamic contrast enhanced magnetic resonance imaging and dynamic susceptibility contrast magnetic resonance imaging in grading of glioma

作　　者：黄杰[1] 李晓光[1] 康厚艺[1] 张玉龙[1] 张伟国[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所放射科,重庆400042

出　　处：《第三军医大学学报》2015年第7期672-677,共6页Journal of Third Military Medical University

基　　金：重庆市自然科学基金重点项目(CSTC2012jj B10028);第三军医大学临床科研基金(2009XLC29)~~

摘　　要：目的定量分析T1加权动态对比增强成像(DCE-MRI)中的参数(Ktrans、Ve)和T*2加权动态磁敏感增强灌注成像(DSC-MRI)中的参数(r CBV、r CBF)与肿瘤病理分级的相关性,比较DCE-MRI及DSC-MRI参数在脑胶质瘤分级诊断中的价值。方法病理证实的85例脑胶质瘤患者,低级别胶质瘤36例,高级别胶质瘤49例。患者在术前行DCE-MRI成像或/和DSC-MRI成像,以相应后处理软件获得灌注参数值。采用单因素方差分析比较不同级别胶质瘤Ktrans与Ve值及r CBV与r CBF值与肿瘤病理分级的差异,应用Pearson相关系数分析Ktrans、Ve值及r CBV、r CBF值与胶质瘤级别之间的相关性。应用ROC曲线分析获得Ktrans、Ve值及r CBV与r CBF值鉴别不同级别胶质瘤的最佳阈值及其敏感性和特异性。结果高级别胶质瘤的平均Ktrans及Ve值均显著高于低级别胶质瘤[分别为(0.157±0.177)/min-1vs(0.029±0.020)/min-1;(0.601±0.246)vs(0.118±0.062),P<0.01]。当Ktrans=0.055/min-1时其诊断敏感性及特异性分别为89.7%和90.5%,当Ve=0.343时其诊断敏感性及特异性分别为86.2%和85.7%。高级别胶质瘤的平均r CBV及r CBF值均显著高于低级别胶质瘤[(2.649±1.351)vs(1.480±0.391);(2.427±1.248)vs(1.377±0.545),P<0.01]。当r CBV=2.043时其诊断敏感性及特异性分别95.2%和92.9%,当r CBF=1.886时其诊断敏感性及特异性分别为85.7%和85.7%。结论 Ktrans与Ve值,r CBV与r CBF值用于脑胶质瘤分级均具有较强相关性,而r CBV是敏感性及特异性最高的参数,其次是Ktrans、Ve和r CBF。Objective To analyze the correlation of the parameters derived from dynamic contrast enhanced magnetic resonance imaging （DCE-MRI）, Ktrans （volume transfer constant） and Ve （volume fraction of extravascular extracellular space ）, and those from dynamic susceptibility contrast magnetic resonance imaging （DSC-MRI） , rCBV （relative cerebral blood volume） and rCBF （relative cerebral blood flow） with the grades of glioma, and compare the values of the parameters in the grading. Methods A total of 85 patients with different types of pathologically confirmed gliomas, including 39 with low grade gliomas （LGGs） and 46 with high grade gliomas （HGGs）, firstly diagnosed in our hospital from September 2013 to September 2014 were enrolled in this study. DSC MRI and/or DCE-MRI were performed on the patients before surgery, and the corresponding perfusion parameters were obtained after software processing. Analysis of variance （ANOVA） was used to compare the maximal values of Ktrans, Ve, rCBV and rCBF among those gliomas of different grades. Pearson correlation analyses were used to determine correlation of Ktrans, Ve, rCBV, and rCBF with glioma grades. Receiver operating characteristic （ROC） curve analyses were carried out to determine the threshold for Ktrans, Ve , rCBV and rCBF to distinguish different grades of gliomas. Results The mean values of Ktrans and Ve were significantly higher in HGG than LGG （0.118 ± 0.062 vs 0. 029 ± 0. 020/min^-1, 0. 601 -＋0. 246 vs 0. 157 ＋0. 177, both P 〈0.001 ）. When the threshold value of Ktrans was 0. 055/min^-1, the sensitivity and specificity were 89.7% and 90.5%, respectively. And when the value of Ve was 0. 343, the sensitivity and specificity were 86.2% and 85.7%, respectively. The mean values of rCBV and rCBF were significantly higher in HGG （2. 649 ± 1. 351 and 2. 427 ± 1. 248, respectively） than LGG （1.480 ±0.391 and 1. 377 ±0. 545, both P 〈0. 001）. The threshold values of rCBV （2. 043） and rCBF （1. 886） provi

关 键 词：胶质瘤 动态对比增强灌注成像 动态磁敏感增强灌注成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.264[医药卫生—诊断学]