磁共振弥散张量成像结合弥散张量纤维束成像在脑胶质瘤分级及诊断中的应用价值  

Application Value of Magnetic Resonance DTI And DTT Imaging in Classification And Diagnosis of Glioma

作　　者：黄和平[1] 孙毅[1] 郭桂兰[2] HUANG He-ping;SUN Yi;GUO Gui-lan(Chenzhou First People's Hospital Imaging Medicine Center,Chenzhou 423000,Hunan Province,China;Chenzhou First People's Hospital Ultrasound Medical Center,Chenzhou 423000,Hunan Province,China)

机构地区：[1]郴州市第一人民医院影像医学中心,湖南郴州423000 [2]郴州市第一人民医院超声医学中心,湖南郴州423000

出　　处：《中国CT和MRI杂志》2022年第9期19-21,共3页Chinese Journal of CT and MRI

摘　　要：目的 探讨弥散张量成像(DTI)联合弥散张量纤维束成像(DTT)在脑胶质瘤分级诊断中的应用价值。方法 选取我院2016年1月到2017年6月收治的40例经病理证实的脑胶质瘤患者作为本次研究的对象。根据患者情况将其分为高级别组和低级别组,所有患者进行DTI,并绘制各向异性分数(FA)图,得到DTI,选取肿瘤实质,瘤周水肿带及水肿边缘作为感兴趣区,对两组瘤体、瘤周水肿带的rFA值、rADC值及DTT进行比较,并观察白质纤维束在肿瘤周围发生的变化。结果 瘤体周围水肿带rFA值在高级别组与低级别组中均大于瘤体rFA值(P<0.05);高级别组和低级别组的瘤体周围水肿带及瘤体比较中,rFA值均无统计学意义(P>0.05);在周围水肿带与瘤体的rADC值比较中,高级别组均低于低级别组(P<0.001),且胶质瘤的级别越高,导致纤维束浸润、破坏和推移的程度越强(Z=-3.646.,P<0.001);低级别组中纤维束部分存在部分中断和偏移,多处于受压状态,但结构基本完整;高级别组中纤维束明显中断稀疏,且存在明显变形。结论 DTI+DTT能够有效地对脑胶质瘤进行较准确的分级诊断,并完整的显示出周围脑白质神经纤维与肿瘤的关系以及改变,为胶质瘤手术前、手术结果 的观察和预后提供科学有效、完整的影像学依据。Objective The study aimed to evaluate application value of diff usion tensor imaging(DTI) and(Diff usion tensor tractography,DTT) in the diagnosis of brain glioma gradation.Methods Selected from January2016 to June 2017 were 40 cases diagnosed and confirmed by pathology of cerebral glioma patients as the research object,according to the classification standard,divided the patients into low level group high level group,patients in the conventional diffusion tensor imaging(cou rsing together tensor imaging,DTI) and magnetic resonance imaging(MRI),map FA,get the diffusion tensor imaging of the bundle(coursing together tensor tractography,DTT),select tumor nature,The edema edge and peritumor edema were divided into points of interest,and the rFA value,rADC value and DTT value of the tumor and the surrounding edema zone were compared and analyzed in the two groups,and the changes of white matter fiber bundles around the tumor were observed.Results The RFA value of peritumoral edema zone in high-grade group and low-grade group was higher than that in tumor body(P<0.05);There was no significant difference in RFA value between high-grade group and low-grade group(P>0.05);In the compa rison of rADC values of peripheral edema zone and tumor body,the highgrade group was lower than the low-grade group(P<0.001),and the higher the grade of gliomas,the more serious the infiltration,displacement and destruction of fibrous bundles(z=-3.646,P<0.001);In the low-level group,the fiber bundles were partially interrupted and offset,most of them were under pressure,but the structure was basically complete;In the high-grade group,the fiber bundles were obviously interrupted and sparse,and there were obvious deformation.Conclusion diffusion tensor imaging(coursing together tensor imaging,DTI) joint diffusion tensor imaging of the bundle(coursing together tensor tra ctography,DTT) effectively accu rate classification diagnosis of glioma,comprehensive and detailed show surrounding brain white matter changes in nerve fibers,and the relations

关 键 词：弥散张量成像 弥散张量纤维束成像 脑胶质瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R651.1[医药卫生—诊断学]