体素内不相干运动扩散加权磁共振成像在脑肿瘤鉴别诊断及术前分级中的临床应用  

Clinical application of voxel independent diffusion-weighted MR imaging in differential diagnosis and preoperative grading of brain tumors

作　　者：黄昊[1] 刘亚斌[1] 张志[1] 白琛[1] 骆伟[1] 王卫[1] HUANG Hao LIU Yabin ZHANG Zhi BAI Chen LUO Wei WANG Wei(Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, China)

机构地区：[1]成都医学院第一附属医院放射科,四川成都610500

出　　处：《西部医学》2017年第4期546-550,共5页Medical Journal of West China

基　　金：四川省科技支撑计划项目(2013SZ02564)

摘　　要：目的探讨多b值体素内不相干运动扩散加权磁共振成像(introvoxelincoherentmotion MR imaging,IVIM-MRI)定量参数在脑肿瘤鉴别诊断及术前分级中的临床价值。方法选择在我院治疗并实施磁共振检查的脑肿瘤患者64例,根据病理学检查结果确定肿瘤类别及病理分级,并据此对患者进行分组。结果在脑肿瘤鉴别诊断方面,良性肿瘤组患者ADC standard、D和D*值均显著高于恶性脑肿瘤患者(P<0.05);良性脑肿瘤患者f值显著低于恶性脑肿瘤患者(P<0.05);ADC standard的AUC最大,敏感性、特异性分别为97.4%,77.4%,同时D值的药时曲线下面积(AUC)敏感性、特异性均较高。在脑肿瘤术前分级方面,低级别脑胶质瘤组与高级别脑胶质瘤组患者ADC standard差异无统计学意义(P>0.05)。低级别脑胶质瘤组患者D、f和D*值均显著低于高级别脑胶质瘤(P<0.05);D*的AUC最大,对不同级别脑胶质瘤诊断的敏感度、特异度分别为94.7%,84.9%。结论单指数模型ADC值与多指数模型D值在脑肿瘤鉴别诊断中均具有较高的临床价值,且多指数模型D值还可用于脑肿瘤的术前分级。Objective To investigate the clinical value of quantitative parameter of multiple value IVIM-MRI in the diagnosis and preoperative grade evaluated of brain tumors. Methods 64 patients with brain tumors, examined by mag- netic resonance imaging, treated in our hospital was selected. The classification of tumor and pathological grade were de- termined according to the pathological examination, and the patients were divided into groups according to the classifica- tion of tumor and pathological grade. Results In the differential diagnosis of brain tumors, the value of ADC standard, D and D ＊ in benign tumor group were significantly higher than those in malignant brain tumors group （P〈0.05）. The f value in benign brain tumor group was significantly lower than that of malignant brain tumor patients （P〈0.05）. The AUC of ADC standard was the highest among f, ADC standard, D and D ＊ , and its sensitivity and specificity on differ- ential diagnosis of brain tumors were 97.4%, 77.4%. AUC, sensitivity and specificity of the D value was also higher. In the preoperative grading of brain tumors, there was no statistically significant of ADC standard between low grade glio- mas and high grade gliomas （P〉0.05）. The value of D, F and D ＊ in low grade gliomas were significantly lower than those in high-grade gliomas （P〈0.05）. and the AUC of D ＊ was the highest among f, ADC standard, D and D ＊ , The diagnosis sensitivity and specificity of D ＊ on different levels of brain glioma 94. 7%, 84. 9%, respectively. Conclusion ADC value of single index model and D value of multiple index model have higher clinicaI value in differential diagnosis of brain tumors. The multiple index model D value has higher clinical value in preoperative grading of brain

关 键 词：多b值IVIM-MRI定量参数 脑肿瘤鉴别诊断 术前分级 临床价值 

分 类 号：R445.2[医药卫生—影像医学与核医学]