动态增强磁共振在听神经鞘瘤中的应用研究  

Application of dynamic contrast-enhanced MRI in acoustic schwannoma

作　　者：姚一焓 张岩松[1] Yao Yihan;Zhang Yansong(Department of Neurosurgery,The Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院神经外科,南京210029

出　　处：《中华脑科疾病与康复杂志（电子版）》2020年第4期218-224,共7页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

基　　金：南京市卫生青年人才第一层次培养项目(QRX11010)。

摘　　要：目的研究动态增强磁共振成像(DCE-MRI)中的各参数指标对听神经鞘瘤的血供来源评估中的应用价值,为听神经鞘瘤的临床治疗提供客观的分析依据。方法纳入南京医科大学附属脑科医院神经外科自2019年9月至2021年1月收治的16例听神经鞘瘤患者为研究对象,同时选择8例无听神经鞘瘤病史患者为对照组。16例听神经鞘瘤患者均于术前行常规MRI平扫+增强,再行DCE-MRI扫描,注射对比剂之后,根据DCE-MRI图像强化部位分为内听道组(6例)和颅内组(10例);对照组行DCE-MRI扫描。应用PHILIPS影像处理工作站对所有DCE-MRI图像进行后处理,获取时间-信号强度曲线(TIC)及半定量参数:最大信号强度(SImax)、达峰时间(TTP)、最大上升斜率(MSI)、对比剂摄取率(WIR)。将对照组、内听道组及颅内组的TIC类型构成及半定量参数值进行统计学分析,采用χ2检验及Kruskal-Wallis检验进行组间比较。结果对照组TICⅠ、Ⅱ、Ⅲ型分别为8、0、0例,内听道组分别为0、1、5例,颅内组分别为4、6、0例,3组比较差异均有统计学意义(P<0.05);内听道组与颅内组比较,差异有统计学意义(P<0.05)。对照组SImax、TTP、MSI、WIR均小于内听道组和颅内组,差异均有统计学意义(P<0.05);内听道组SImax、TTP、WIR与颅内组比较,差异均无统计学意义(P>0.05);内听道组MSI大于颅内组,差异有统计学意义(P<0.05)。结论DCE-MRI的TIC及半定量参数中的MSI对于鉴别听神经鞘瘤的血供来源是经颅内(椎-基底动脉系统)还是内听道(颈外动脉分支)有一定意义。Objective To study the application value of various parameters in dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in evaluating the blood supply of acoustic schwannoma,and to provide objective analysis basis for clinical treatment of acoustic schwannoma.Methods Sixteen patients with acoustic schwannoma admitted to neurosurgery department of the Affiliated Brain Hospital of Nanjing Medical University from September 2019 to January 2021 were selected as the research objects,and 8 patients without acoustic schwannoma history were selected as the control group.Sixteen cases of acoustic neurilemmoma were performed conventional MRI scan and contrast enhancement before operation,and then underwent DCE-MRI scan.After injection of contrast agent,they were divided into internal auditory canal group(6 cases)and intracranial group(10 cases)according to the enhancement site of DCE-MRI image;the control group underwent DCE-MRI scan.All DCE-MRI images were post processed by Philips image processing workstation to obtain tic curve and semi quantitative parameters,including maximum signal intensity(SImax),time to peak(TTP),maximum slope of increase(MSI),wash in rate(WIR).The time signal intensity curve(TIC)types and semi-quantitative parameter values of the control group,internal auditory canal group and intracranial group were statistically analyzed,and theχ2 test and Kruskal-Wallis test were used for comparison between groups.Results In the control group,TICs of typeⅠ,ⅡandⅢwere 8,0,and 0 cases,respectively.In the internal auditory canal group,TICs of typeⅠ,ⅡandⅢwere 0,1,and 5 cases,respectively.In the intracranial group,TICs wereⅠ,ⅡandⅢwere 4,6,and 0 cases,respectively.The difference between the control group and the internal auditory canal group,intracranial group was statistically significant(P<0.05);Comparing the internal auditory canal group with the intracranial group,the difference was statistically significant(P<0.05).SImax,TTP,MSI,WIR of control group are all lower than those of the inter

关 键 词：听神经鞘瘤 动态增强磁共振 血液供应 半定量参数 

分 类 号：R739.4[医药卫生—肿瘤]