动态对比增强MRI联合动态磁敏感对比增强MRI鉴别诊断Ⅱ级与Ⅲ级胶质瘤  

Dynamic contrast-enhanced MRI and dynamic susceptibility contrast MRI for differential diagnosis of gradeⅡandⅢglioma

作　　者：姚巧丽 梁知遇 朱凯 李晓丹 严承功[1,2] 许乙凯 YAO Qiaoli;LIANG Zhiyu;ZHU Kai;LI Xiaodan;YAN Chenggong;XU Yikai(Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;Guangdong Provincial Key Laboratory of Shock and Microcirculation, Guangzhou 510515, China;Key Laboratory of Mental Health of the Ministry of Education, Southern Medical University, Guangzhou 510515, China)

机构地区：[1]南方医科大学南方医院医学影像中心,广东广州510515 [2]广东省休克微循环重点实验室,广东广州510515 [3]南方医科大学精神健康研究教育部重点实验室,广东广州510515

出　　处：《中国介入影像与治疗学》2021年第8期459-464,共6页Chinese Journal of Interventional Imaging and Therapy

基　　金：教育部创新团队发展计划(IRT_16R37)。

摘　　要：目的观察动态对比增强MRI(DCE-MRI)联合动态磁敏感对比增强MRI(DSC-MRI)鉴别Ⅱ级与Ⅲ级胶质瘤的价值。方法回顾性分析术前接受常规序列、DCE及DSC MR检查并经术后病理确诊的47例胶质瘤,Ⅱ级31例、Ⅲ级16例,对比组间相关参数,采用受试者工作特征(ROC)曲线分析各参数对Ⅱ级与Ⅲ级胶质瘤的鉴别诊断效能。结果Ⅲ级胶质瘤DCE-MRI参数容积转运常数(Ktrans)和时间-信号强度曲线下面积(riAUC)均高于Ⅱ级,DSC-MRI参数相对脑血容量(rCBV)、相对脑血流量(rCBF)及平均通过时间(MTT)亦均高于Ⅱ级(P均<0.05)。对于鉴别Ⅱ级与Ⅲ级胶质瘤,DCE-MRI参数中Ktrans的曲线下面积(AUC)最大,为0.75;DSC-MRI参数中rCBV的AUC最大,为0.80。联合采用Ktrans、rCBV二者串联鉴别诊断Ⅱ级与Ⅲ级胶质瘤的敏感度为60.16%,特异度92.51%;二者并联敏感度为96.09%,特异度52.66%。结论DCE-MRI及DSC-MRI均可用于鉴别诊断Ⅱ级与Ⅲ级胶质瘤;二者联合鉴别诊断价值更高。Objective To explore the value of dynamic contrast-enhanced MRI(DCE-MRI)and dynamic susceptibility contrast MRI(DSC-MRI)for distinguishing gradeⅡandⅢgliomas.Methods Data of 47 patients with glioma diagnosed pathologically who underwent conventional sequence,DCE and DSC MR examination before operation were retrospectively analyzed,including 31 cases of gradeⅡ(gradeⅡgroup)and 16 cases of gradeⅢgliomas(gradeⅢgroup).The related parameters were compared between groups.The receiver operating characteristic(ROC)curves were drawn to analyze the efficacies of the parameters for differential diagnosis of gradeⅡand gradeⅢglioma.Results In gradeⅢgroup,DCE-MRI parameters of the volume transfer constant(Ktrans)and initial area under the signal intensity-time curve(riAUC)were higher than those in gradeⅡgroup(both P<0.05),while DSC-MRI parameters of the relative cerebral blood volume(rCBV),relative cerebral blood flow(rCBF)and mean transit time(MTT)were higher than those in gradeⅡgroup(all P<0.05).Ktrans had the largest area under the curve(AUC,0.75)among DCE-MRI parameters,while rCBV had the largest AUC(0.80)among DSC-MRI parameters for distinguishing gradeⅡandⅢgliomas.The sensitivity of Ktrans serial rCBV for distinguishing gradeⅡandⅢgliomas was 60.16%,and the specificity was 92.51%,whereas the sensitivity and specificity of the above 2 parameters in parallel was 96.09%and 52.66%,respectively.Conclusion Both DCE-MRI and DSC-MRI could be used to distinguish gradeⅡandⅢglioma.Combination of DCE-MRI and DSC-MRI might bring higher differential diagnosis value.

关 键 词：胶质瘤 磁共振成像 病理学 临床 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]