灌注加权成像与神经突方向分散度和密度成像鉴别脑胶质瘤复发与放射性坏死的价值  

The value of perfusion-weighted imaging and neuroprocess directional dispersion and density imaging in differentiating brain glioma recurrence from radiation necrosiss

作　　者：陈欢[1] 王红[1] 郝璐[1] 杨毅[1] CHEN Huan;WANG Hong;HAO Lu(Department of Medical Imaging,Second Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China)

机构地区：[1]新疆医科大学第二附属医院医学影像科,新疆乌鲁木齐830000

出　　处：《临床和实验医学杂志》2021年第20期2222-2226,共5页Journal of Clinical and Experimental Medicine

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(编号:WJWY-202209);新疆维吾尔自治区自然科学基金项目(编号:2021D01C370)。

摘　　要：目的探究灌注加权成像(PWI)与神经突方向分散度和密度成像(NODDI)鉴别脑胶质瘤复发与放射性坏死的价值。方法前瞻性选取2018年12月至2020年6月于新疆医科大学第二附属医院进行胶质瘤术后放疗的80例患者进行灌注加权成像与神经突方向分散度和密度成像,经过神经突方向分散度和密度成像得到odi图、ficvf图、fvec图、浓度参数的沃森分布图(kappa)及各向同性体积分数图(fiso);经过灌注加权成像得到转运常数(K^(trans))、血管外细胞外间隙体积百分数(V e)、速率常数(K ep)及半定量参数iAUC的值。同时分析联合应用灌注加权成像与神经突方向分散度和密度成像在肿瘤复发与放射性损伤中的价值。结果本研究80例患者中有57例脑胶质瘤放射性脑坏死患者,23例脑胶质瘤复发患者。复发组和坏死组脑胶质瘤的fiso、fxvec、fyvec、fzvec、kappa、ficvf、odi的平均值可鉴别水肿与正常区,差异均有统计学意义(P<0.05)。脑胶质瘤复发组K^(trans)值、V e值和iAUC值均显著高于坏死组,差异均有统计学意义(P<0.05),而两组Ke P值差异无统计学意义(P>0.05)。复发组和坏死组患者检查过程中和检查后主要不良反应发生率比较差异均无统计学意义(P>0.05)。二者联合对对胶质瘤复发和坏死检出率诊断效能指标灵敏度、特异度、阳性预测值、阴性预测值和诊断准确率均显著高于仅采用灌注加权成像和神经突方向分散度和密度成像(P<0.05)。结论灌注加权成像与神经突方向分散度和密度成像鉴别脑胶质瘤复发与放射性坏死应用价值较高,值得临床推广使用。Objective To explore the value of perfusion weighted imaging(PWI),neurite orientation dispersion and density imaging(NODDI)in differentiating recurrent glioma from radiation necrosis.Methods From December 2018 to June 2020,80 patients undergoing postoperative radiotherapy for glioma in the Second Affiliated Hospital of Xinjiang Medical University were selected for perfuse-weighted imaging and neuroprocess direction dispersion and density imaging.Fiso,fxvec,fyvec,fzvec,kappa,ficvf,odi of concentration parameters were obtained by neuroprocess direction dispersion and density imaging.The values of transport constant(K^(trans)),extracellular space volume percentage(V e),rate constant(K ep)and semi-quantitative parameter iAUC were obtained by perfusion weighted imaging.At the same time,the value of perfusion weighted imaging combined with neurite directional dispersion and density imaging in tumor recurrence and radiation injury was analyzed.Results Among the 80 patients in this study,there were 57 patients with radioactive brain necrosis of glioma and 23 patients with recurrence of glioma.The mean values of fiso,fxvec,fyvec,fzvec,kappa,ficvf,odi of glioma in recurrent and necrotic groups could distinguish edema from normal areas,and the differences were statistically significant(P<0.05).The K^(trans),V e and iAUC values of the glioma recurrence group were significantly higher than those of the necrosis group after treatment,and the differences were statistically significant(P<0.05),while the difference in K ep values between the two groups was not statistically significant(P>0.05).There was no statistical significance in the incidence of major adverse reactions between the recurrence group and the necrosis group during and after examination(P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of the diagnostic efficacy indexes for the detection rate of glioma recurrence and necrosis were significantly higher than those of perfusion weighted imaging,neuroproce

关 键 词：灌注加权成像 神经突方向分散度和密度成像 脑胶质瘤复发 放射性坏死 

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]