T2DSCPWI和弥散加权成像在单发脑转移瘤和高级别胶质瘤的诊断中的应用比较  

Application Comparison of T2DSCPWI and Diffusion-Weighted Imaging in the Diagnosis of Brain Metastases and High-Grade Gliomas

作　　者：张晓瑞[1] 申静[2] 王华锋[1] 李建丽 李艳景 杨素君[1] 王玉芳[1] ZHANG Xiao-rui;SHEN Jing;WANG Hua-feng(Department of CT,Handan Central Hospital of Hebei Province Handan 0560019 China;Department of Nuclear Medicine,Handan Central Hospital of Hebei Province Handan 0560019 China)

机构地区：[1]邯郸市中心医院CT室,河北邯郸056001 [2]邯郸市中心医院核医学科,河北邯郸056001 [3]河北省曲周县医院放射科,河北曲周057250

出　　处：《中国实验诊断学》2020年第2期199-203,共5页Chinese Journal of Laboratory Diagnosis

基　　金：河北省2017年医学科学研究重点课题(课题编号2017-1133)。

摘　　要：目的探究T2*动态磁敏感对比增强灌注加权成像(DSC PWI)及弥散加权成像(DWI)在单发脑转移瘤及胶质瘤中的鉴别价值。方法选取在本院进行治疗的122例高级别胶质瘤以及45例单发脑转移瘤患者进行研究,术前进行MRI常规扫描、T2DSCPWI扫描以及DWI扫描,对两组患者肿瘤实质区以及瘤周水肿区表观弥散系数(ADC)、相对表观弥散系数(rADC)、相对脑血流(rCBF)、相对脑血容量(rCBV)进行测量,制作受试者工作特征曲线(ROC)评估rCBF、rCBV、ADC、rADC在脑转移瘤和胶质瘤中的鉴别价值。结果两组肿瘤实质区以及瘤周水肿区灌注情况、信号比较,无显著差异(P>0.05)。脑转移瘤瘤周水肿区ADC、rADC均显著高于高级别胶质瘤,rCBV、rCBF显著低于高级别胶质瘤(P<0.05)。瘤周水肿区ADC、rADC、rCBF、rCBV对脑转移瘤诊断的AUC值为0.841、0.857、0.793、0.827。结论单发脑转移瘤患者瘤周水肿区T2DSCPWI参数rCBF、rCBV及DWI参数ADC、rADC均高于高级别脑胶质瘤者,在单发脑转移瘤和胶质瘤的鉴别中具有一定的诊断价值。Objective To explore the differential value of T2* dynamic magnetic sensitivity contrast enhanced perfusion weighted imaging(DSC PWI)and diffusion weighted imaging(DWI)in brain metastases and gliomas.Methods122 cases of high-grade glioma patients and 45 cases of single brain metastasis patients treated in our hospital were studied,all patients were routine MRI scan,T2 DSCPWI scan,and DWI scan were performed before operation,the apparent diffusion coefficient(ADC),relative apparent diffusion coefficient(rADC),relative cerebral blood flow(rCBF),and relative cerebral blood volume(rCBV)in the parenchymal and peritumoral edema areas of the two groups were measured,receiver operating characteristic curve(ROC)was made to evaluate the differential values of rCBF,rCBV,ADC,and rADC in brain metastases and gliomas.Results There was no significant difference in perfusion and signal between the two groups(P>0.05).ADC and rADC in peritumoral edema area of brain metastases were significantly higher than those of high-grade gliomas,and rCBV and rCBF were significantly lower than those of high-grade gliomas(P<0.05).The AUC values of ADC,rADC,rCBF and rCBV in the peritumoral edema area were 0.841,0.857,0.793 and 0.827 for the diagnosis of brain metastases.Conclusion The parameters of T2 DSCPWI,rCBF,rCBV and DWI,ADC and rADC in peritumoral edema of patients with single brain metastases are higher than those of high-grade gliomas,and have certain diagnostic value in the differential diagnosis between single brain metastases and gliomas.

关 键 词：脑转移瘤 高级别胶质瘤 动态磁敏感对比增强灌注加权成像 弥散加权成像 诊断价值 

分 类 号：R739.41[医药卫生—肿瘤]