CE-MRA、T_(1)WI、三维薄层T_(1)WI序列评价脑肿瘤血供的对照研究  

Comparison of CE-MRA,T_(1)WI and 3D-T_(1)WI sequence in evaluation of brain tumor blood supply

作　　者：蓝海龙 王琪[1] 李东[1] 周雁玲 肖叶玉 Lan Hailong;Wang Qi;Li Dong;Zhou Yanling;Xiao Yeyu(Department of Medical Imaging,Wuchuan People′s Hospital,Wuchuan 524500,China;Department of Radiology,the Affiliated Xiaolan Hospital of Southern Medical University,Zhongshang 528400,China;Department of Medical Imaging,Guangzhou Hospital of Integrated Traditional and West Medicine,Guangzhou 510000,China)

机构地区：[1]广东省吴川市人民医院医学影像中心,524500 [2]南方医科大学附属小榄医院放射科,中山528400 [3]广州市中西结合医院医学影像科,510000

出　　处：《中国医师杂志》2021年第5期693-697,共5页Journal of Chinese Physician

基　　金：广东省科技创新战略专项资金(2018A0303070002);广东省中医药局科研项目(20202141)。

摘　　要：目的对照研究对比剂增强磁共振血管造影(CE-MRA)、T_(1)WI、三维薄层T_(1)WI序列在评价脑肿瘤血供的诊断效能,旨在改良脑肿瘤磁共振增强扫描方案。方法29例脑肿瘤患者注射对比剂后,依次扫描CE-MRA、T_(1)WI、三维薄层T_(1)WI序列,分别就"观察瘤实质强化"、"观察瘤体内小血管"、"观察瘤周小血管"的影像表现进行定性分级,应用McNemar卡方检验分析三种序列的诊断差异。结果⑴在"观察瘤实质强化"方面,CE-MRA、T_(1)WI、三维薄层T_(1)WI序列诊断达A1级(瘤体强化,图像清晰,与非强化区分界锐利)者分别为0例、8例(27.59%)、19例(65.52%),三维薄层T_(1)WI序列诊断效能优于T_(1)WI序列(P<0.05),T_(1)WI序列优于CE-MRA序列(P<0.05)。⑵在"观察瘤体内小血管"方面,CE-MRA、T_(1)WI、三维薄层T_(1)WI序列诊断达B1级(可清晰观察瘤体内小血管,并能追踪上级血管)者分别为8例(27.59%)、5例(17.24%)、16例(55.17%),三维薄层T_(1)WI序列诊断效能优于T_(1)WI序列与CE-MRA序列(P<0.05)。⑶在"观察瘤周小血管"方面,CE-MRA、T_(1)WI、三维薄层T_(1)WI序列诊断达C1级(可清晰显示瘤体与邻近血管关系)者分别为18例(62.07%)、5例(17.24%)、14例(48.28%),CE-MRA、三维薄层T_(1)WI序列诊断效能优于T_(1)WI序列(P<0.05)。结论联合三维薄层T_(1)WI与CE-MRA序列可全面评估瘤体血供,对脑肿瘤定位、定性、指导治疗具有重要意义。Objective To evaluate the diagnostic efficiency of contrast-enhanced magnetic resonance angiography(CE-MRA),T_(1)WI and three-dimensional thin-layer T_(1)WI sequences(3D-T_(1)WI)in evaluating the blood supply of brain tumors,so as to improve the enhanced magnetic resonance imaging(MRI)scanning scheme of brain tumors.Methods After the contrast agent was injected,29 patients with brain tumors were scanned with CE-MRA,T_(1)WI and 3D-T_(1)WI.The imaging manifestations of"observing the enhancement of tumor substance","observing the small vessels in the tumor body"and"observing the small vessels around the tumor"were qualitatively classified,and the diagnostic differences of the three sequences were analyzed by McNemar test.Results⑴In the aspect of"observing the contrast medium in the tumor body",CE-MRA,T_(1)WI and 3D-T_(1)WI sequences diagnosed as grade A1 were 0 cases,8 cases(27.59%)and 19 cases(65.52%)respectively.The diagnostic efficiency of 3D-T_(1)WI sequences was better than that of T_(1)WI sequence(P<0.05),and T_(1)WI sequence was better than that of CE-MRA sequence(P<0.05).⑵In the aspect of"observing the small vessels in the tumor",CE-MRA,T_(1)WI and 3D-T_(1)WI sequences diagnosed as grade B1 were 8 cases(27.59%),5 cases(17.24%)and 16 cases(55.17%),respectively.The diagnostic efficiency of 3D-T_(1)WI was better than that of T_(1)WI and CE-MRA(P<0.05).⑶In the aspect of"observing the small vessels around the tumor",CE-MRA,T_(1)WI and 3D-T_(1)WI sequences diagnosed as grade C1 were 18 cases(62.07%),5 cases(17.24%)and 14 cases(48.28%)respectively.The diagnostic efficiency of CE-MRA and 3D-T_(1)WI wre better than that of T_(1)WI(P<0.05).Conclusions The combination of 3D-T_(1)WI and CE-MRA sequence can comprehensively evaluate the blood supply of the tumor,which is of great significance for the localization,characterization and treatment of brain tumors.

关 键 词：脑肿瘤 血液供应 磁共振血管造影术 成像 三维 

分 类 号：R739.41[医药卫生—肿瘤]