脑转移瘤伽玛刀CT与MRI定位的差异分析  

Difference analysis between CT and MRI in the positioning of gamma knife surgery for brain metastases

作　　者：胡良运 钟山[1] 薛俊 江泓[2] 潘斯俭[1] Hu Liangyun;Zhong Shan;Xue Jun;Jiang Hong;Pan Sijian(Department of Stereotactic and Functional Neurosurgery,School of Medicine,Shanghai Jiaotong University,Shanghai 200025,China;Department of Neurosurgery,Ruijin Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院功能神经外科,200025 [2]上海交通大学医学院附属瑞金医院神经外科,200025

出　　处：《中国微侵袭神经外科杂志》2019年第10期448-451,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨脑转移瘤MRI及CT扫描肿瘤大小差异及其相互关系,为伽玛刀治疗脑转移瘤选择合适的定位手段。方法回顾性分析11例明确诊断的脑转移瘤病人的临床资料,分别行头部MRI T1WI 3D增强扫描及CT增强扫描,通过Perfexion伽玛刀手术治疗计划系统进行图像融合和分析,对比MRI和CT对应层面肿瘤大小差异及相互关系。结果MRI测定的肿瘤直径显著大于CT扫描肿瘤大小(P<0.0001)。MRI与CT间肿瘤直径差值分别与MRI和CT单独测定的肿瘤直径呈正相关(r=0.6787,P<0.0001;r=0.5617,P<0.0001)。ROC曲线显示:与5 mm层厚CT比较,0.625 mm层厚CT测定的肿瘤大小更接近MRI测定值。结论MRI是脑转移瘤诊断和伽玛刀治疗定位的首选方法,如有MRI禁忌证,0.625 mm层厚CT可作为伽玛刀定位的备选方案。Objective To explore the differences and the correlations between the diameters detected by MRI and CT scan to choose a suitable positioning method of gamma knife surgery for brain metastasis.Methods Clinical data of 11 patients who were definitively diagnosed as brain metastasis were analyzed retrospectively.All the patients were scanned by 3D-enhanced T1WI of MRI scan and CT enhanced scan method.Perfexion gamma knife surgery treatment plan system was used for image fusion and analysis.The diameters of tumors measured by MRI and CT were compared and their correlations were analyzed.Results The diameters measured by MRI were significantly larger than those by CT(P<0.0001).The difference in tumor diameter between MRI and CT was significantly positively correlated with the tumor diameters detected by MRI and CT respectively(r=0.6787,P<0.0001;r=0.5617,P<0.0001).ROC curve showed that the diameters measured by 0.625 mm thickness of CT were more close to the diameters measured by MRI than the 5 mm thickness of CT.Conclusions MRI is the first choice for diagnosis of brain metastasis and treatment positioning of gamma knife.If there is MRI contraindication,0.625 mm thickness CT is an alternative method for positioning of gamma knife surgery.

关 键 词：脑肿瘤 肿瘤转移 磁共振成像 体层摄影术 X-线计算机 伽玛刀 

分 类 号：R739.41[医药卫生—肿瘤] R815[医药卫生—临床医学]