MR灌注成像联合血清神经元特异性烯醇化酶在肺癌脑转移瘤中的应用  

Application of MR perfusion imaging combined with serum neuron-specific enolase in lung cancer brain metastases

作　　者：曹桢斌[1] 杨艳艳 刁志宏 徐莉萍[1] 黄宝胜 CAO Zhenbin;YANG Yanyan;DIAO Zhihong;XU Liping;HUANG Baosheng(Department of Medical Imaging,Ruikang Hospital,Guangxi University of Traditional Chinese Medicine,Nanning 530011,China;Department of Laboratory Medicine,Ruikang Hospital,Guangxi University of Traditional Chinese Medicine,Nanning 530011,China)

机构地区：[1]广西中医药大学附属瑞康医院医学影像科,广西南宁530011 [2]广西中医药大学附属瑞康医院检验科,广西南宁530011

出　　处：《实用放射学杂志》2021年第12期1946-1950,共5页Journal of Practical Radiology

摘　　要：目的研究动态磁敏感增强(DSC)相对脑血流量(rCBF)、最大相对脑血容量(rCBVmax)值联合血清神经元特异性烯醇化酶(NSE)在评估肺癌脑转移瘤患者疗效及预后中的预测价值。方法选取181例非小细胞肺癌(NSCLC)患者,其中转移45例,未转移136例。检测血清NSE水平,分析DSC灌注成像,测量rCBF值以及rCBVmax值。比较各组患者指标变化情况,绘制受试者工作特征(ROC)曲线,评估联合检测对脑转移瘤、预后的诊断效能。结果脑转移组、未转移组患者血清NSE水平为(47.52±11.23)μg/L、(34.37±9.53)μg/L,差异有统计学意义(P<0.05)。NSE诊断脑转移的曲线下面积(AUC)为0.800[95%置信区间(CI)0.688~0.911],诊断敏感度、特异度分别为92.90%、65.20%。治疗后肿瘤强化区的rCBF、rCBVmax值以及血清NSE水平均明显降低(P<0.05)。转移组死亡率高于未转移组(P<0.05)。脑转移患者中死亡组治疗前、治疗后的rCBF、rCBVmax值以及血清NSE水平明显高于存活组(P<0.05),而变化值差异无统计学意义(P>0.05)。rCBF、rCBVmax值以及血清NSE联合预测脑转移患者预后的AUC为0.889(95%CI 0.788~0.990),明显高于单独预测的AUC(P<0.05)。结论DSC的rCBF值、rCBVmax值以及血清NSE水平可有效评估肺癌脑转移瘤患者的疗效,3个指标联合检测可有效提高预后诊断效能。Objective To study the predictive value of curative effect and prognosis of dynamic susceptibility contrast(DSC)relative cerebral blood flow(rCBF)and maximum relative cerebral blood volume(rCBVmax)combined with serum neuron-specific enolase(NSE)in lung cancer patients with brain metastases.Methods 181 patients with non-small cell lung cancer(NSCLC)admitted were selected,including 45 cases with metastasis and 136 cases without metastasis.The level of serum NSE was detected,DSC perfusion imaging was analyzed,and the rCBF and rCBVmax values were measured.The changes in the indicators of patients in each group were compared,and the receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of combined detection for brain metastases and prognosis.Results The serum NSE levels of patients in the brain metastasis group and non-metastasis group were(47.52±11.23)μg/L and(34.37±9.53)μg/L,the difference was statistically significant(P<0.05).The area under the curve(AUC)for NSE diagnosis of brain metastases was 0.800[95%confidence interval(CI)0.688-0.911],the diagnostic sensitivity and specificity were 92.90%,65.20%.The rCBF,rCBVmax value of tumor enhancement area and serum NSE level decreased significantly after treatment(P<0.05).The mortality rate of metastasis group was higher than that of non-metastasis group(P<C0.05).In patients with brain metastases,the rCBF,rCBVmax and serum NSE levels before and after treatment in the death group were significantly higher than those in the survival group(P<0.05),but there was no significant difference in the changes(P>0.05).The AUC of the combined predictions of rCBF,rCBVmax value and serum NSE level for the prognosis of patients with brain metastases was 0.889(95%CI 0.788-0.990),which was significantly higher than that predicted separately(P<0.05).Conclusion DSC-rCBF,rCBVmax and serum NSE can effectively evaluate the curative effect of patients with brain metastases of lung cancer,and the combined detection of three indexes can effectively improve t

关 键 词：相对脑血流量 最大相对脑血容量 非小细胞肺癌 神经元特异性烯醇化酶 脑转移 

分 类 号：R734.2[医药卫生—肿瘤] R739.41[医药卫生—临床医学]