基于MRI鉴别星形细胞瘤4级和胶质母细胞瘤  

Distinguish Grade 4 Astrocytoma from Glioblastoma based on MRI

作　　者：方萍 赵雪梅[1] 王利娜[1] 李晓舒[1] 王啸[1] 钱银锋[1] FANG Ping;ZHAO Xue-mei;WANG Li-na;LI Xiao-shu;WANG Xiao;QIAN Yin-feng(Department of Radiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui Province,China)

机构地区：[1]安徽医科大学第一附属医院放射科,安徽合肥230022

出　　处：《中国CT和MRI杂志》2023年第3期9-11,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨星形细胞瘤4级和胶质母细胞瘤的MRI影像学特征。方法选取我院2017年4月至2021年9月经手术病理证实的26个星形细胞瘤4级和37个胶质母细胞瘤,所有患者均行MRI检查。观察患者年龄、性别及肿瘤出血、囊变、肿瘤横断面最大径、囊变横断面最大径、囊变最大径与肿瘤最大径比值、流空血管征象、表观扩散系数(ADC值及基于肿瘤全域的ADC直方图)等指标并进行统计学分析。结果星形细胞瘤4级囊变最大径较胶.质母细胞瘤囊变最大径小,差异有统计学意义(P=0000);囊变最大径与肿.瘤最大径比值两组病例之间差异有统计学意义(P=0000);胶质母细胞瘤.更容易出现流空血管征象,差.异有统计学意义(P=.0003);ADC直方图中方差(P=0005)和离均差(P=0025)差异有统计学意义。而年龄、性别、有无出血、有无囊变均无统计学意义。结论星形细胞瘤4级和胶质母细胞瘤在囊变最大径、囊变最大径与肿瘤最大径的比值及肿瘤内流空血管征象、ADC直方图表现上存在差异,MRI可作为术前初步区分两种肿瘤的非侵入性检查方法。Objective To evaluate MRI imaging features of grade 4 astrocytoma and glioblastoma.Methods Twentysix lesions of grade 4 astrocytoma and 37 lesions of glioblastoma confirmed by surgical pathology in our hospital from April 2017 to September 2021 were selected.All patients underwent MRI examination.Age,gender,hemorrhage,cystic lesions,maximum cross-sectional diameter of tumor,maximum cross-sectional diameter of cystic lesions,ratio of maximum diameter of cystic lesions to maximum diameter of tumor,flow void vessel signs,apparent diffusion coefficient(ADC value and tumor-based ADC histogram)were observed and statistically analyzed.Results The maximum diameter of cystic part in astrocytoma was smaller than that in glioblastoma,and the difference was statistically significant(P=0.000).The ratio of maximum diameter of cystic part to maximum diameter of tumor was significantly different between the two groups(P=0.000).Glioblastoma was more likely to show signs of flow void vessels,and the difference was statistically significant(P=0.003).There were statistically significant differences between ADC histogram variance(P=0.005)and mean absolute deviation(P=0.025).There was no statistical significance in age,sex,hemorrhage and cystic changes.Conclusion There were differences between grade 4 astrocytoma and glioblastoma in the maximum diameter of cystic part,the ratio of the maximum diameter of cystic part to the maximum diameter of tumor,the signs of flow void and the performance of ADC histogram.MRI can be used as a noninvasive method to preliminarily distinguish between the two tumors before surgery.

关 键 词：胶质母细胞瘤 星形细胞瘤4级 异柠檬酸脱氢酶 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]