磁共振扩散加权成像联合波谱成像评估脑胶质瘤级别的应用价值  

Application value of diffusion-weighted magnetic resonance imaging combined with spectral imaging in evaluating glioma grade

作　　者：张照明[1] 于向锋 宋吉慧[1] Zhang Zhaoming;Yu Xiangfeng;Song Jihui(Department of Radiology,Xinhua Hospital,Dalian University,Dalian 116021,China)

机构地区：[1]大连大学附属新华医院放射科,辽宁大连116021

出　　处：《临床荟萃》2020年第12期1106-1110,共5页Clinical Focus

摘　　要：目的探究扩散加权成像(DWI)联合波谱成像技术(MRS)在评估胶质瘤等级中的临床应用价值。方法回顾性分析自2017年1月至2020年8月就诊于大连大学附属新华医院的103例脑胶质瘤患者的临床资料。根据WHO中枢神经系统肿瘤分类,将病例分为两组:低级别胶质瘤(LGG)组(54例)和高级别胶质瘤(HGG)组(49例)。比较两组术前的磁共振检查结果中扩散系数(ADC),相对扩散系数(rADC))、胆碱(Cho)、肌酸(Cr)和N-乙醇天门东氨酸(NAA)的差异性。结果HGG组和LGG组中,ADC的比值分别为(1.51±0.47)×10^-3 mm^2/s和(1.37±0.29)×10^-3 mm^2/s(P<0.01);rADC比值分别为(1.87±0.49)×10^-3 mm^2/s和(1.66±0.37)×10^-3 mm^2/s(P<0.01);Cho/Cr的比值分别为2.21±0.46和4.02±0.48(P<0.01);Cho/NAA的比值分别为2.19±0.41和4.21±0.58(P<0.01);NAA/Cr的比值分别为0.81±0.22和0.47±0.11(P<0.01)。受试者工作特征曲线(ROC)结果显示ADC、rADC、Cho/Cr、Cho/NAA和NAA/Cr的曲线下面积分别为0.750、0.842、0.766、0.801及0.751,差异均有统计学意义。结论DWI及MRS在术前评估脑胶质瘤级别方面具有很高的应用价值,弥补了MRI常规序列的不足,对临床医生诊疗方案的制定起指导作用。Objective To explore the clinical value of diffusion-weighted imaging(DWI)in the assessment of glioma grade combined with magnetic resonance spectroscopy(MRS).Methods The clinical data of 103 patients with glioma who visited Xinhua Hospital affiliated to Dalian University from January 2017 to August 2020 were retrospectively analyzed.According to the World Health Organization(WHO)classification of central nervous system tumors,the patients were divided into two groups:low-grade glioma(LGG)group(54 cases)and high-grade glioma(HGG)group(49 cases).The results of the diffusion coefficient(ADC),relative apparent diffusion coefficient(rADC),choline(Cho),Creatine(Cr)and N-ethanol tianmendong(NAA)in each group were comparatively assessed.Results The ADC value were in LGG and HGG group were(1.51±0.47)×10^-3 mm^2/s and(1.37±0.29)×10^-3 mm^2/s(P<0.01)respectively;The rADC value in LGG and HGG group were(1.87±0.49)×10^-3 mm^2/s and(1.66±0.37)×10^-3 mm^2/s(P<0.01)respectively;the ratio of Cho/Cr in LGG and HGG group were 2.21±0.46 and 4.02±0.48(P<0.01)respectively;The ratio of Cho/NAA in LGG and HGG group were 2.19±0.41 and 4.21±0.58(P<0.01)respectively;the ratios of NAA/Cr in LGG and HGG group were 0.81±0.22 and 0.47±0.11(P<0.01)respectively.The results of receiver operating characteristic(ROC)curve showed that the area under the curve of ADC,rADC,Cho/Cr,Cho/NAA and NAA/Cr were 0.750,0.842,0.766,0.801 and 0.751,respectively,which were all statistically significant.Conclusion DWI and MRS have high application value in preoperative assessment of glioma grade,which complement the deficiency of conventional MRI sequence and play a guiding role in the formulation of clinical doctors'diagnosis and treatment plan.

关 键 词：肿瘤 神经上皮 磁共振成像 磁共振波谱学 诊断 

分 类 号：R730.264[医药卫生—肿瘤]