双源CT与头部MRI灌注成像对诊断原发性颅脑肿瘤的价值对比  

Comparison of DSCT and MRI perfusion imaging in diagnosis of primary craniocerebral tumors

作　　者：王宪莉 肖新广 谷梅兰 李润华 邢威[2] WANG Xianli;XIAO Xinguang;GU Meilan;LI Runhua;XING Wei(Department of Radiology,Zhengzhou Central Hospital,Zhengzhou University,Zhengzhou,Henan 450000,China;Department of Magnetic Resonance,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学附属郑州中心医院放射科,河南郑州450000 [2]河南中医药大学第一附属医院磁共振科,河南郑州450000

出　　处：《中国医学工程》2023年第1期19-22,共4页China Medical Engineering

摘　　要：目的分析双源CT(DSCT)与头部核磁共振成像(MRI)灌注成像对诊断原发性颅脑肿瘤(PBT)的价值对比。方法选择2019年1月至2021年12月来郑州大学附属郑州中心医院诊断的63例疑似原发性颅脑肿瘤患者作为研究对象,按照诊断方法分为DSCT组(实验组),头部MRI灌注成像组(对照组),对比两组诊断方法的灵敏度、准确性、特异度和图像特征。结果实验组诊断符合星形细胞瘤34例(53.97%),脑膜瘤14例(22.22%),室管膜肿瘤4例(6.35%),髓母细胞瘤4例(6.35%),对照组诊断符合星形细胞瘤30例(47.62%),脑膜瘤10例(15.87%),室管膜肿瘤4例(6.35%),髓母细胞瘤2例(3.17%)。实验组<2 cm的病灶的准确率高于对照组,检测2~4 cm准确率高于对照组(P<0.05)。实验组检查方法的灵敏度、特异度、准确度均高于对照组(P<0.05)。两者检测的图像表现差异较大:①星形细胞瘤:实验组呈现低密度病灶,边界多数清晰,对照组检查边缘不清晰,多囊变、坏死。②脑膜瘤:实验组平扫为高密度分布,少数等密度,出血、坏死、囊变较少,对照组扫描后内部信号不均匀,血管丰富。③室管膜肿瘤:实验组平扫呈现等密度、混杂密度肿块,对照组扫描可见肿块影。④髓母细胞瘤:实验组可见低密度圆形肿瘤,对照组变化不明显。结论DSCT对PBT诊断的灵敏度、特异度、准确性高于MRI灌注成像,更有利于指导临床医生对颅内多种肿瘤进行鉴别。【Objective】Comparison of dual source CT(DSCT)and head magnetic resonance imaging(MRI)perfusion imaging in the diagnosis of primary craniocerebral tumors.【Methods】Sixty-three patients with suspected primary brain tumors(PBT)diagnosed in our hospital from January 2019 to December 2021 were divided into DSCT group(experimental group)and MRI perfusion group(control group)according to the diagnostic method.【Results】There were 34 cases(53.97%)of astrocytoma,14 cases(22.22%)of meningioma,4 cases(6.35%)of ependymoma and 4(6.35%)cases of medulloblastoma in the experimental group,30 cases(47.62%)of astrocytoma,10 cases(15.87%)of meningioma,4 cases(6.35%)of ependymoma and 2 cases(3.17%)of medulloblastoma in the control group.The accuracy of lesions<2 cm in the experimental group was higher than that in the control group,and the accuracy of 2–4 cm was higher than that in the control group(P<0.05).The sensitivity,specificity and accuracy of the test method in the experimental group were higher than those in the control group(P<0.05).There were great differences between the two images:(1)Astrocytoma:the experimental group showed low-density lesions,most of the boundaries were clear,and the edge of the control group was not clear,polycystic and necrotic.(2)Meningioma:the experimental group showed highdensity distribution,a few equal density,less bleeding,necrosis and cystic degeneration.The internal signals in the control group were uneven and abundant blood vessels after scanning.(3)Ependymal tumor:the experimental group showed equal density and mixed density mass on plain scan,while the control group showed mass shadow on scan.(4)Medulloblastoma:low density round tumor can be seen in the experimental group,but the change was not obvious in the control group.【Conclusion】DSCT is more sensitive,specific and accurate than MRI perfusion imaging in the diagnosis of PBT,which is more conducive to guide clinicians to distinguish various intracranial tumors.

关 键 词：双源CT 核磁共振成像灌注成像 诊断原发性颅脑肿瘤 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]