3.0T MR 3D-PCASL技术在脑胶质瘤微灌注研究  

A study of 3D-PCASL in brain gliomas at 3.0T MR

作　　者：廖海波[1,2] 肖新兰[2] 戴中强 刘征华[2] 于建华[2] 王志强[2] 金文晶[2] 吴雷[4] 沈晓黎[4] 汪建华[1] 

机构地区：[1]宁波大学医学院附属医院MRI室,浙江宁波315000 [2]南昌大学第二附属医院MRI室 [3]广东省揭阳市普宁市中医院CT室 [4]南昌大学第二附属医院神经外科

出　　处：《实用放射学杂志》2016年第3期441-444,451,共5页Journal of Practical Radiology

基　　金：浙江省医药卫生科技计划项目（2015108954）;宁波大学科研基金项目（xyy15072）.

摘　　要：摘要：目的评价3D伪连续动脉自旋标记技术（3DPcAsL）在脑胶质瘤术前分级价值。方法回顾性分析经组织病理学证实的20例低级别脑胶质瘤及21例高级别脑胶质瘤的3D-PCASL图像，应用感兴趣区（ROI）分别得到肿瘤实体（TBF）、肿瘤边缘1cm内水肿区、肿瘤边缘1～2cm内水肿区以及对侧正常灰质、白质的脑血流量（CBF），对各参数值进行统计学分析。结果在高、低级别脑胶质瘤组间，除了肿瘤边缘1～2cm水肿区的CBF无统计学意义外（P〉0．05），其他参数值均有统计学意义（P％0．001）；在高级别胶质瘤组中，不同区域CBF值两两比较均有统计学意义（P〈0．05），而在低级别胶质瘤组中肿瘤边缘1cm水肿区与肿瘤边缘1～2cm水肿区的CBF无统计学意义（P〉0.05），其他区域两两相比均有统计学意义（P〈0.05）。受试者工作特征曲线（R0c）曲线下面积（AUC）最大的为TBF／对侧灰质rCBF值，AUC为0．96，当阈值为2时，其敏感性和特异性也最高，分别为85．7％和100％。配对x。检验常规序列的诊断准确率为76％，结合3D-PCASL技术后诊断正确率为93％，2种方法比较有统计学意义（χ^2=6．61，P=0．01）。结论3D-PCASI，有助于提高脑胶质瘤术前分级准确率，TBF／对侧灰质的rCBF值为分级最佳参数值。Objective To evaluate the value of 3D-PCASL in the pre-operation brain gliomas-grading. Methods 3DPCASL images of 41 cases of gliomas comfirmed by pathology, including 20 cases of low-grade and 21 cases of high-grade were retrospectively analyzed. The cerebral blood flows of the solid region of tumor （TBF） ,1cm and 1 cm-2 cm brain tissue around the tumor,and eontralateral normal brain CBF were obtained based on the region of interest （ROI} ,respectively. Results According to independent sample t-test,all had statistically significant differences （P〈0. 00） between high and low-grade gliomas except the 1-2 cm region around the tumor. One-way ANO- VA displayed that all of them had its statistically significant between differences region （P〈0. 001） in high-grade gliomas,which had statisti cally significant differences （P〈0. 001（ except 1 cm and 1-2 cm of peri-tumor in low-grade gliomas. ROC curve analysis of TBF/ contralateral gray matter showed that the area under the curve was 0.96. When 2 was chosen as threshold of rCBF, there was the highest sensitivity （85.7%） and specificity （100%）. The accurate rate of conventional MRI for gliomas dianosis was 76 % and the ac curate rate of conventional MRI with ASL was 93%, which was statistically significant difference （χ^2= 6.61, P= 0.01 ） between two methodson the chi-scluare test. Conclusion 3D-PCASL can improve the accuracy of diagnosis of different grade brain gliomas. Com- pared with others parameters, rCBF have a higher sensitivity and specificity.

关 键 词：伪连续动脉自旋标记 胶质瘤 微灌注 磁共振成像 

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