1.5TMRI扫描PWI成像评估脑星形细胞瘤WHO分级诊断的效果  

Effect of 1.5T magnetic resonance perfusion-weighted imaging in evaluating the WHO classification of cerebral astrocytoma

作　　者：李辉 蔡定萍 姚俊 LI Hui;CAI Ding-ping;YAO Jun(Imaging Center,Ankang Central Hospital,Ankang 725000,Shaanxi,CHINA)

机构地区：[1]安康市中心医院影像中心,陕西安康725000

出　　处：《海南医学》2022年第24期3225-3228,共4页Hainan Medical Journal

基　　金：陕西省自然科学基础研究计划(编号:2020JM-703)。

摘　　要：目的 分析1.5T核磁共振成像(MRI)扫描灌注加权(PWI)成像评估脑星形细胞瘤WHO分级诊断的效果。方法 选取2019年3月至2022年1月安康市中心医院收治且经手术病理确诊的125例脑星形细胞瘤为研究对象,根据组织病理分级,其中低级别组(WHOⅠ~Ⅱ级) 61例,高级别组(WHOⅢ~Ⅳ级) 64例。比较不同级别星形细胞瘤的血流灌注参数变化;采用Pearson相关评估相对脑血容量(rCBV)值、相对脑血流量(rCBF)值、相对平均通过时间(rMTT)与病理分级相关性;以手术病理结果为金标准,应用准确度、灵敏度、特异度、阳性预测值及阴性预测值分析灌注参数的诊断价值。结果 高级别组患者的rCBV、rCBF分别为4.26±2.17、2.34±1.34,明显高于低级别组的1.42±0.38、1.23±0.26,差异均有统计学意义(P<0.05),但两组患者的r MTT比较差异无统计学意义(P>0.05);经Pearson相关分析结果显示,rCBV、rCBF与病理分级呈正相关(r=0.426、0.563,P<0.05),而rMTT与病理分级无相关性(r=0.006,P>0.05);以手术病理结果为金标准,MRI平扫+增强对高、低级别星形细胞瘤分级诊断准确度为65.23%、灵敏性为68.33%、特异性为63.27%,PWI成像中rCBV准确度为83.96%,阳性预测值为91.56%;rCBF准确度为81.73%,阳性预测值为90.43%;rMTT准确度为77.53%,阳性预测值为88.26%。结论 MRI扫描PWI成像对脑星形细胞瘤WHO分级诊断效果良好,对于后续治疗和预后指导具有重要价值。Objective To analyze the effect of 1.5T magnetic resonance perfusion-weighted imaging(PWI) in assessing the WHO classification of cerebral astrocytoma. Methods A total of 125 patients of cerebral astrocytoma admitted to Ankang Central Hospital from March 2019 to January 2022 and confirmed by surgery and pathology were selected as the research objects. According to the histopathological grade, 61 cases were included in the low-grade group(WHO grades Ⅰ-Ⅱ) and 64 cases in the high-grade group(WHO grades Ⅲ-Ⅳ). The changes of blood perfusion parameters of different levels of astrocytoma were compared. Pearson correlation was used to evaluate the correlation between relative cerebral blood volume(rCBV), relative cerebral blood flow(rCBF), relative average transit time(rMTT) and pathological grading. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were used to analyze the diagnostic value of perfusion parameters with surgical and pathological results as the gold standard.Results The rCBV and rCBF of the high-grade group were 4.26±2.17, 2.34±1.34, respectively, which were significantly higher than 1.42±0.38, 1.23±0.26 of the low-grade group(P<0.05), but there was no significant difference in rMTT between the two groups(P>0.05). According to the Pearson correlation analysis, r CBV and r CBF were positively correlated with pathological grade(r=0.426, 0.563, P<0.05), but r MTT was not correlated with pathological grade(r=0.006, P>0.05).Taking surgical and pathological results as the gold standard, the accuracy, sensitivity, and specificity of plain scan and enhanced MRI in the diagnosis of high-and low-grade astrocytoma were 65.23%, 68.33%, and 63.27%, respectively. In PWI imaging, the accuracy of rCBV was 83.96%, and the positive predictive value was 91.56%;the accuracy of rCBF was81.73%, and the positive predictive value was 90.43%;the accuracy of rMTT was 77.53%, and the positive predictive value was 88.26%. Conclusion 1.5T magnetic resonance perfusion-weighted

关 键 词：1.5T核磁共振成像 灌注加权成像 脑星形细胞瘤 WHO分级 诊断价值 

分 类 号：R739.41[医药卫生—肿瘤]