基于ISHIM序列的IVIM-DWI成像在星形细胞肿瘤分级中的应用  

Value of IVIM-DWI based on ISHIM sequence in astrocytic tumor grading

作　　者：张洁[1] 姜兴岳[1] 白岩[1] 邹雪雪 聂泰明[1] 杨明瑞[1] 石清磊 

机构地区：[1]滨州医学院附属医院,山东省滨州市256603 [2]西门子(中国)有限公司磁共振产品事业部,北京市100102

出　　处：《实用医学杂志》2017年第8期1262-1265,共4页The Journal of Practical Medicine

基　　金：山东省自然科学基金(编号:ZR2011HL038)

摘　　要：目的:探讨基于ISHIM序列的IVIM-DWI在颅脑星形细胞肿瘤分级中的应用价值。方法:收集经病理证实的星形细胞肿瘤患者42例,高、低级别肿瘤分别为28例(Ⅲ级10例、IV级18例)、14例(Ⅰ级1例、Ⅱ级13例)。所有患者均行常规MRI、ISHIM IVIM-DWI及增强扫描。测量肿瘤实质区、周围水肿区及对侧正常脑白质区参数值,并进行统计学分析。结果:肿瘤实质区:高级别组D值低于低级别组,D*值、f值均高于低级别组,差异且均具有统计学意义;周围水肿区:高级别组D值低于低级别组,差异具有统计学意义,D*值、f值间差异无统计学意义;高、低级别组对侧正常脑白质区D、D*、f值的差异均无统计学意义。结论:基于ISHIM的IVIM-DWI成像获得的D、D*、f值有助于肿瘤级别的判定,在高低级别星形细胞肿瘤的鉴别诊断中具有较大的应用价值。Objective To investigate the value of intravoxel incoherent motion （IVIM） diffusion-weighted imaging （DWI） based on ISHIM sequence in the grading of astrocytic tumor. Methods We collected excised tumors confirmed by histological diagnosis from 42 patients including high-grade astrocytic tumors （ 10 WHO grade Ⅲ , 18 WHO grade Ⅳ ） , and 14 low-grade astrocytic tumors （1 WHO grade Ⅰ and 13 WHO grade Ⅱ ）. All patients underwent conventional MR imaging, ISHIM IVIM-DWI, and contrast-enhanced MR imaging. Parameters of tumor parenchyma region, peripheral edema regions and the eontralateral normal brain white matter sites were measured, and the statistical analysis was conducted. Results The D value in tumor parenchyma region was significantly lower, but the D＊ and f values were higher in high-grade astrocytic tumor when compared with lowgrade one and all had statistical significance ; in tumor peripheral edema region, D value was lower in high-grade astrocytic tumor than that in low-grade one, and the difference had statistical significance but there was no significant difference in terms of the D＊ and f values. There was no significant difference of the D, D＊ and f values in contralateral normal brain white matter sites in both high- and low-grade astrocytic tumor. Conclusion The D, D＊ and f values measured by ISHIM IVIM-DWI are helpful to the judgment of tumor grade and it has great application value in the differential diagnosis of high- and low-grade astrocytic tumor.

关 键 词：IVIM-DWI ISHIM 星形细胞肿瘤 

分 类 号：R739.4[医药卫生—肿瘤]