磁共振灌注加权成像预测原发性中枢神经系统淋巴瘤无进展生存期的价值  

Predictive Value of MR Perfusion-Weighted Imaging in the Progression-Free Survival of Primary Central Nervous System Lymphoma

作　　者：王肖 邓雪飞[2] 宋伟[1] 谭德力 朱友志[1] 骆祥伟[1] 张禹[1] WANG Xiao;DENG Xuefei;SONG Wei;et al(Department of Medical Imaging, The 105th Hospital of PLA, Hefei 230031, P. R. China)

机构地区：[1]中国人民解放军105医院医学影像科,合肥230031 [2]安徽医科大学人体解剖教研室,合肥230032

出　　处：《临床放射学杂志》2018年第3期379-385,共7页Journal of Clinical Radiology

基　　金：安徽省卫生和计划生育委员会科研计划项目(全科医学临床科研课题)(基金编号2016QK080)

摘　　要：目的探讨磁共振灌注加权成像（PWI）对原发性中枢神经系统淋巴瘤（PCNSL）无进展生存期（PFS）的预测价值。方法回顾性分析经病理证实的21例PCNSL治疗前PWI表现及临床资料。在PWI参数值图上分别测量肿瘤的相对脑血容量（rCBV）、相对脑血流量（rCBF）、相对平均通过时间（rMTT）、相对达峰时间（rTTP）值并获取各参数值的最小值、平均值、最大值,将各参数值与正常侧半卵圆中心各参数值的平均值比较后计算得出比值并逐一记录。根据所得各参数值比值的平均值、PFS的中位值分别列为高低两组,统计参数值比值高低两组的不同PFS病例数百分比后进行卡方检验。结果 rCBV最大值比值高低两组、rCBF最大值比值高低两组之间的不同PFS组的病例数具有统计学差异（P〈0.05）,其余参数值比值高低两组之间的高低PFS组之间的病例数不具有统计学差异。结论 PWI的参数值能够在治疗前初步判断PCNSL患者的基于大剂量甲氨蝶呤（MTX）化疗的PFS。Objective To investigate the value on predicting progression free survival（ PFS） in primary central nervous system lymphoma（ PCNSL） by the means of perfusion-weighted imaging（ PWI）. Methods We analyzed the characteristics of PWI in 21 patients diagnosed with primary central nervous system lymphomas,which were confirmed by pathology before treatment. The relative cerebral blood volume（ rCBV）,relative cerebral blood flow（ rCBF）,relative mean transit time（ rMTT） and relative time to peak（ rTTP） were measured on PWI images. The minimum,mean and maximum values of every parameter were recorded on enhanced tumors. The values of parameters were compared with the mean values of parameters of normal centrum semiovale. The ratio was calculated and recorded. The high and low group were defined according to the results of the mean value of the ratio of each parameter and the median PFS. Chi-square test was performed between the high and low group. Results The number of patients has significant difference in the groups of the maximum rCBV（ P 0. 05） as well as in the groups of the maximum rCBF between different PFS groups. The number of patients did not have significant difference in the rest of the parameters between high PFS group and low group. Conclusion PWI could predict the prognosis of patients with PCNSL based on high-dose methotrexate-based chemotherapy before treatment.

关 键 词：中枢神经系统淋巴瘤 灌注加权成像 化疗 无进展生存期 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.4[医药卫生—诊断学]