弥散张量成像在胶质母细胞瘤诊断中的价值  

The value of DTI in the diagnosis of glioblastoma

作　　者：肖道雄 刘晓玉 刘招琪 赖丙林 范存庚 罗书华 王晓春 严群 彭吉东 XIAO Dao-xiong;LIU Xiao-yu;LIU Zhao-qi;LAI Bing-lin;FAN Cun-geng;LUO Shu-hua;WANG Xiao-chun;YAN Qun;PENG Ji-dong(Department of Medical Imaging,Ganzhou Hospital Affiliated to Nanchang University,Ganzhou People's Hospital,Ganzhou,Jiangxi 341000)

机构地区：[1]南昌大学附属赣州医院赣州市人民医院医学影像科,江西赣州341000

出　　处：《赣南医学院学报》2021年第9期942-947,共6页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：江西省卫生健康委员会科技计划项目(20197306)。

摘　　要：目的:探讨磁共振弥散张量成像(Diffusion tensor imaging,DTI)在胶质母细胞瘤(Glioblastoma,GBM)影像诊断中的价值。方法:收集2014年2月至2020年8月经术后病理证实的胶质母细胞瘤46例,同时收集Ⅰ~Ⅲ级星形细胞瘤(54例)、脑脓肿(14例)、脑膜瘤(42例)及脑转移瘤(22例)作为对照。分别观察病灶在DTI-FA图上的表现,包括病灶边缘有无FA高信号环(Round_FA)、边缘FA值(Rim_FA)和ADC值(Rim_ADC)、病灶内FA值(In_FA)和ADC值(In_ADC)、周围1 cm FA值(Out_FA)和ADC值(Out_ADC),统计分析胶质母细胞瘤的不同区域FA值、ADC值的差异以及胶质母细胞瘤与对照组的不同区域FA值、ADC值的差异。结果:在胶质母细胞瘤的不同区域的FA值、ADC值中,In_FA值(0.085±0.040)最低,In_ADC值(1.839±0.643)最高,不同区域的FA值、ADC值差异均有统计学意义(P<0.05)。在胶质母细胞瘤、脑脓肿、脑膜瘤、脑转移瘤的FA图上,FA高信号环均常见,其中胶质母细胞瘤完整的FA高信号环(Round_FA=1)的发生率约35%(16/46),后3者的发生率高达77%以上。胶质母细胞瘤与脑膜瘤的In_FA、Rim_FA值,胶质母细胞瘤与脑脓肿、脑膜瘤的Out_FA、In_ADC值,两两比较差异有统计学意义(P<0.05)。胶质母细胞瘤的Rim_ADC值、Out_ADC值与各对照组比较,差异无统计学意义(P>0.05)。胶质母细胞瘤与脑脓肿、脑膜瘤的Out_FA-In_FA差值、In_ADC-Out_ADC差值之间差异有统计学意义(P<0.05)。结论:基于DTI-FA图分析胶质母细胞瘤可提供更多量化信息特征,有助于术前准确诊断该病。Objective:To investigate the value of diffusion tensor imaging(DTI)in the diagnosis of glioblastoma(GBM).Methods:A total of 46 cases of glioblastoma pathologically confirmed after surgery from February 2014 to Au⁃gust 2020 were collected,while gradeⅠ-Ⅲastrocytoma(54 cases),brain abscess(14 cases),meningioma(42 cas⁃es)and brain metastases(22 cases)were also collected as control group.The features on DTI-FA map of different re⁃gions of glioblastoma and control group were observed and calculated respectively,including FA high signal ring at the edge of lesions(Round_FA),the average FA and ADC values at the edge of lesions(Rim_FA,Rim_ADC),the average FA and ADC values inside the lesions(In_FA,In_ADC),the average FA and ADC values within 1cm around the le⁃sions(Out_FA,Out_ADC).The differences of FA and ADC values in different regions of glioblastoma and those values between glioblastoma and control group were statistically analyzed.Results:Of different regions of glioblastoma,In_FA value(0.085±0.040)was the lowest,while In_ADC value(1.839±0.643)was the highest.Both FA and ADC values of different regions of glioblastoma showed statistically significant differences(P<0.05).FA high signal ring were common on DTI-FA map of glioblastoma,brain abscess,meningioma and brain metastases.The percentage of“Round_FA=1”was 35%(16/46)in glioblastoma cases,whereas more than 77%in brain abscess,meningioma and brain metastases cases.Moreover,both In_FA and Rim_FA values of glioblastoma showed significant differences with those of meningio⁃ma,while both Out_FA and In_ADC values of glioblastoma showed significant differences with those of both brain ab⁃scess and meningioma.However,neither Rim_ADC nor Out_ADC values of glioblastoma showed significant difference with others.Glioblastoma,brain abscess and meningioma had significant differences(P<0.05)in the deviations of FA(Out_FA minus In_FA)and ADC(In_ADC minus Out_ADC).Conclusion:The analysis of glioblastoma based on DTIFA map could provide more quantitative informa

关 键 词：胶质母细胞瘤 部分各向异性 表观弥散系数 磁共振成像 弥散张量成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]