动态磁化率对比增强MR灌注成像对脑星形细胞瘤分级诊断的价值  

Clinical value of dynamic sueceptibility-weghted contrast-enhanced MR perfusion-weighted imaging in brain astrocytoma grading

作　　者：林祺[1] 邓燕芳[1] 邱清香 汤琅琅[1] 唐平太[1] 谢丽卿 陈金银[1] 何永红[1] 

机构地区：[1]福建医科大学附属龙岩第一医院放射科,龙岩364000

出　　处：《功能与分子医学影像学（电子版）》2016年第2期9-12,共4页Functional and Molecular Medical Imaging(Electronic Edition)

基　　金：福建省医学创新课题基金(2011-CXB-28)

摘　　要：目的探讨动态磁化率对比增强(DSC)MR灌注成像在脑星形细胞瘤分级诊断的价值。方法 75例经手术病理证实的脑星形细胞瘤患者手术前行常规MRI和DSC MR灌注成像扫描,其中低级别星形细胞瘤23例(WHOⅡ级)、间变性星形细胞瘤20例(WHOⅢ级),胶质母细胞瘤32例(WHOⅣ级)。检测瘤实质区和瘤周围区最大相对脑血容量(r CBV_(max))。比较和分析不同级别星形细胞瘤瘤实质区和瘤周围区之间r CBV_(max)的差异。结果瘤实质区Ⅱ、Ⅲ和Ⅳ级星形细胞瘤内r CBV_(max)分别为1.7656±0.0843、4.5501±0.1914、7.6659±0.4666,差异有统计学意义(P<0.001);瘤周围区Ⅱ、Ⅲ和Ⅳ级星形细胞瘤内r CBV_(max)分别为1.1069±0.0312、3.3650±0.1982、5.4385±0.2584,差异有统计学意义(P<0.05)。Ⅱ、Ⅲ和Ⅳ级星形细胞瘤瘤实质区r CBV_(max)评估肿瘤级别效能要优于瘤周围区间的r CBV_(max)(P<0.01)。结论 DSC MR灌注r CBV_(max)能较准确地评估脑星形细胞瘤的病理分级,具有重要临床实用价值。[Abstract] Objective To investigate the clinical value of dynamic susceptibility-weghted contrast- enhanced MR perfusion-weighted imaging （DSC-PWI） in evaluating the grade of astrocytic tumors. Methods 75 patients with astrocytic tumors were enrolled in this study, including gradeⅡ（23）, grade Ⅲ （20）, and grade Ⅳ （ 32）. All of them underwent preoperative conventional MRI, contrast-enhanced MRI and PWI examination. The maximum rCBV （rCBVmax） values of the solid prat of tumor and the peripheral region of tumor were measured. Analysis and compare the differences of the rCBVmax of the solid part tumor and the peripheral region of tumor among different grades. Results The rCBVmax of the solid part of astrocytic tumors for grade Ⅱ ,Ⅲ and Ⅳwere 1.7656 ±0.0843, 4.5501 ± 0.1914, 7.6659 ± 0.4666. Statistically significant differences were found between Ⅱ , Ⅲ and Ⅳ（P 〈 0.001 ）. The rCBVmax of the peripheral region of tumor for grade Ⅱ , Ⅲ and Ⅳ were 1.1069 ± 0.0312, 3.3650 ± 0.1982, 5.4385 ± 0.2584. Statistically significant differences were found between Ⅱ , Ⅲ and Ⅳ（P 〈 0.05 ）. The diagnostic performance of the rCBVmax of the solid part was superior to that of peripheral region in astrocytic tumors （P 〈 0.01 ） Conelusion The pathologic grading of astrocytic tumors can be realized accurately by DSC-PWI using the rCBVmax, which has important clinical practical value.

关 键 词：脑 星形细胞肿瘤 MRI 灌注加权成像 最大相对脑血容量 

分 类 号：R445.2[医药卫生—影像医学与核医学] R793.41[医药卫生—诊断学]