氨基质子转移成像在鉴别脑内转移瘤和高级别胶质瘤中的应用价值  

Application value of amide proton transfer imaging in differential diagnosis of brain metastasis and high grade glioma

作　　者：李锐[1] 吴冰 王玉林[1] 娄昕[1] 马林[1] 

机构地区：[1]解放军总医院放射科,北京100853 [2]通用电器中国医疗,北京100853

出　　处：《第三军医大学学报》2016年第22期2388-2392,共5页Journal of Third Military Medical University

摘　　要：目的探讨基于化学交换饱和转移的氨基质子转移成像在鉴别脑内转移瘤和高级别胶质瘤应用价值。方法收集2015年5月至2016年5月经病理证实的高级别胶质瘤15例,脑转移瘤10例(部分脑转移瘤病例经临床病史证实)。患者均行常规MRI平扫、增强扫描及氨基质子转移成像(amide proton transfer,APT)扫描。分别比较两组病变肿瘤实质区、瘤旁区(即水肿区,若无水肿,实质区周围0.5 cm以内为瘤周区)APT信号强度的差异。结果高级别胶质瘤与转移瘤肿瘤实质区在APT图上均表现为高信号,高级别胶质瘤瘤周区APT图信号强度较转移瘤高;高级别胶质瘤与转移瘤肿瘤实质区APT信号强度分别为(2.89±0.76)%、(2.72±0.68)%,两者比较差异无统计学意义(P=0.177);高级别胶质瘤与转移瘤瘤周区APT信号强度分别为(1.46±0.52)%、(0.71±0.39)%,两者比较差异有统计学意义(P=0.001)。结论氨基质子转移成像(APT)技术通过测量瘤周区APT信号强度对鉴别高级别胶质瘤和脑内转移瘤具有一定参考价值。Objective To determine the value of amide proton transfer （APT） imaging derived from chemical exchange saturation transfer （CEST） in the differential diagnosis between high grade glioma and brain metastasis. Methods A retrospective analysis of 25 patients with pathologically confirmed brain tumors in our hospital from May 2015 to May 2016 were carried out. Among the patients, 15 cases were high grade gliomas and 10 were brain metastasis, which part of the metastases were evidenced by clinical history. Conventional MRI and APT imaging were performed using a 3.0T MRI scanner. The APT signal intensity （SI） was measured in the tumor core regions and tumor surrounding tissues （edema region, or the area at 0.5 em distanced from the tumor core if no obvious edema was found）. The APT SI was compared between high grade glioma and brain metastasis. Results High SI was detected in the tumor core for both high grade glioma and brain metastasis on APT images with corresponding APT SI values of （ 2. 89 ± 0.76 ） % and （2.72 ±0.68 ）% vespectively. The minor difference was not statistically significant between the 2 groups （P = 0. 117）. In contrast, the APT SI of tumor surrounding tissue was significantly higher in high grade gliomas than in brain metastasis, with significant difference [ （ 1.46 ±0.52 ） % vs （0.71± 0.39 ） %, P = 0.001]. Conclusion APT imaging, a novel molecular and cellular MR technique, is useful in differentiating high grade glioma from brain metastasis by measuring the APT SI of tumor surrounding tissue.

关 键 词：高级别胶质瘤 脑转移瘤 氨基质子转移成像 磁共振成像 

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]