DCE-MRI联合MTI在脑胶质瘤分级及浸润中的应用价值  

The Application Value of DCE-MRI Combined MTI in the Grading and Infiltration of Intracerebral Glioma

作　　者：何金龙[1] 高阳[1] 李波 王少彧 张华鹏 HE Jinlong;GAO Yang;LI Bo(Department of Imaging Diagnosis,Affiliated Hospital of Inner Mongolia Medical University,Hohhot010050,P.R.China)

机构地区：[1]内蒙古医科大学附属医院影像诊断科,呼和浩特010050 [2]西门子医疗系统有公司,上海201318

出　　处：《临床放射学杂志》2021年第4期651-655,共5页Journal of Clinical Radiology

基　　金：内蒙古自治区科技计划项目(编号:2019GG047)。

摘　　要：目的探讨动态对比增强磁共振成像(DCE-MRI)联合磁化传递成像(MTI)在胶质瘤分级中的应用价值。方法搜集经病理证实的胶质瘤患者34例,其中高级别组(Ⅲ、Ⅳ级)20例,低级别组(Ⅰ、Ⅱ级)14例。所有患者均行颅脑常规MRI平扫及增强序列(T2WI、T1WI、DWI、CE-T1WI)和DCE-MRI和MTI序列(Mo、Ms)扫描,比较两组患者DCE-MRI的转运常数(K^(trans))、血管外细胞外容积分数(Ve)、速率常数(Kep)、增强曲线下初始面积(iAUC)和MTI的磁化传递率(MTR)。采用SPSS 23.0统计学软件进行数据分析,两组参数值比较采用独立样本t检验,采用受试者工作特征曲线(ROC)分析各参数鉴别诊断高、低级别胶质瘤敏感度、特异度和曲线下面积(AUC)。结果高级别脑胶质瘤组K^(trans)、Ve、iAUC均高于低级别脑胶质瘤组,差异有统计学意义(P<0.05);两组间Kep无明显统计学差异(P>0.05);两组间肿瘤水肿区DCE-MRI各参数差异无统计学意义(P>0.05),MTR差异有统计学意义(P<0.05);两组间高级别组MTR值低于低级别组,差异有统计学意义(P<0.05),DCE-MRI中iAUC、Ve、Ktrans的AUC、敏感度、特异度较高,MTR及Ktrans联合MTR诊断效能未见提高。结论DCE-MRI联合MTI在胶质瘤分级、胶质瘤水肿区浸润程度中有较高的应用价值。Objective To investigate the value of dynamic contrast enhanced MRI(DCE-MRI)combined with magnetic transfer imaging(MTI)in the classification of glioma.Methods 34 cases of glioma confirmed by pathology in our hospital were collected,including 20 cases of high grade gliomas(HGGs)and 14 cases of low grade gliomas(LGGs).All patients were scanned with conventional scan and DCE-MRI enhanced sequence(T2WI,T1WI,DWI,CE-T1WI),and MTI sequence(Mo,MS).The transport constant(K^(trans),extracellular volume fraction(Ve),rate constant(Kep),initial area under the enhancement curve(iAUC)parameter of DCE-MRI and magnetic transfer ratio(MTR)of MTI were compared between the two groups.SPSS 23.0 statistical software was used to analyze the data.Independent sample t-test was used to compare the parameters of the two groups.ROC curve was used to analyze the sensitivity,specificity and area under the curve(AUC)of high and low grade glioma.Results Ktrans,Ve and iAUC in the HGGs group were higher than those in the LGGs group(P<0.05);there was no significant difference in Kep between the two groups(P>0.05);There was no significant difference in DCE-MRI parameters between the two groups of peritumoral edema area(P>0.05),and there was significant difference in MTR(P<0.05).MTR value in the high-grade group was lower than that in the low-grade group(P<0.05.AUC,sensitivity and specificity of iAUC,Ve and K^(trans)in DCE-MRI were higher,but the diagnostic efficiency of MTR and Ktrans combined with MTR was not been improved.Conclusion DCE-MRI combined with MTI has high value in the classification of glioma and the infiltration degree of peritumoral edema of glioma.

关 键 词：动态对比增强 磁化传递成像 胶质瘤分级 瘤周浸润 

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]