三维动脉自旋标记联合扩散加权成像在儿童脑肿瘤分级中的应用  

The Application of 3D Arterial Spin Labeling Combination with Diffusion Weighted Imaging in the Grading of Brain Tumors in Children

作　　者：王冬[1] 胡文 陈超[1] 陈华[1] 侯欣 张增俊[1] WANG Dong;HU Wen;CHEN Chao(Department of Radiology,Xi’an Children’s Hospital,Xi'an 710003,P.R.China)

机构地区：[1]西安市儿童医院放射科,710003

出　　处：《临床放射学杂志》2020年第7期1408-1411,共4页Journal of Clinical Radiology

摘　　要：目的评价三维动脉自旋标记(3D-ASL)联合扩散加权成像(DWI)在儿童脑肿瘤分级中的价值。方法回顾性分析35例经手术病理及免疫组织化学证实的脑肿瘤患儿,术前行3D-ASL及DWI成像。在GE AW 4.6工作站测量肿瘤血流量(TBF)、TBF比值(rTBF)、ADC值,采用独立样本t检验比较高级别(Ⅲ、Ⅳ级)、低级别(Ⅰ、Ⅱ级)肿瘤的TBF、rTBF及ADC值,利用受试者工作特征曲线评价各参数的诊断效能。结果高级别肿瘤TBF值显著高于低级别肿瘤(t=4.991,P<0.001)。高级别肿瘤rTBF值显著高于低级别肿瘤(t=4.687,P<0.001)。高级别肿瘤ADC值显著低于低级别肿瘤(t=-6.362,P<0.001)。TBF、rTBF、ADC值对肿瘤分级的曲线下面积(AUC)分别为0.892、0.918、0.971。rTBF联合ADC值对肿瘤分级的AUC为0.985,rTBF联合ADC值诊断的敏感性和特异性分别为100%及95%。结论3D-ASL及DWI对儿童脑肿瘤分级有重要价值,联合分析rTBF及ADC值能进一步提高儿童脑肿瘤分级的敏感性和特异性。Objective The present study aimed to evaluate the role of 3 D Arterial Spin Labeling(3 D-ASL)combination with Diffusion Weighted Imaging(DWI)in grading of brain tumors in children.Methods A total of 35 children with postoperative histopathology confirmed brain tumors were enrolled in this study.3 D-ASL and DWI images were retrospectively evaluated.Tumor blood flow(TBF)values,relative Tumor blood flow(rTBF)values and ADC values were measured on a GE work station.The Student’s t test was used to evaluate differences in the parameters of 3 D-ASL and DWI between low and high grade groups.Receiver operator characteristic(ROC)analysis was used to assess the diagnostic performance.Results The TBF of high grade tumors was significantly higher than that of low grade tumors(t=4.991,P<0.001).The rTBF of high grade tumors was significantly higher than that of low grade tumors(t=4.687,P<0.001).The ADC of high grade tumors was significantly lower than that of low grade tumors(t=-6.362,P<0.001).In ROC analysis,the AUC of TBF,rTBF and ADC were 0.892,0.918 and 0.971 respectively.The AUC of rTBF combination with ADC was 0.985,corresponding sensitivity and specificity was 100%and 95%.Conclusion 3 D-ASL and DWI are useful for separating low and high grade brain tumors in children.If ADC and rCBF values are combined,the diagnostic accuracy is optimized.

关 键 词：动脉自旋标记 扩散加权成像 脑肿瘤 儿童 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]