3D-ASL及IVIM在高级别脑胶质瘤术后复发和放射性脑损伤中的应用  

Application of 3D-ASL and IVIM in postoperative recurrence and radiation brain injury of high-grade glioma

作　　者：褚玉玄 王建伟[1] CHU Yuxuan;WANG Jianwei(The First Affiliated Hospital of Nanjing Medical University/Jiangsu Provincial People's Hospital,Nanjing 210000,China)

机构地区：[1]南京医科大学第一附属医院江苏省人民医院,江苏南京210000

出　　处：《中国实用神经疾病杂志》2023年第4期410-415,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨三维动脉自旋标记(3D-ASL)及体素内不相干运动(IVIM)在高级别脑胶质瘤术后复发和放射性脑损伤中的作用。方法回顾性分析2018-01—2022-09南京医科大学第一附属医院60例高级别脑胶质瘤患者,根据随访结果或二次手术结果分为复发组(n=23,术后复发)和损伤组(n=37,放射性脑损伤),所有患者均进行3D-ASL、IVIM检查,经ROC曲线分析3D-ASL、IVIM的诊断效能。结果复发组患者的D^(*)(2.46±0.58)10^(-3)mm/s、f(0.59±0.17)、rCBF(3.06±0.96)、CBF(26.79±3.48)均高于损伤组(P<0.05)。经ROC曲线分析,D^(*)、f、rCBF、CBF及4项联合鉴别脑胶质瘤术后复发和放射性脑损伤的AUC分别为0.834、0.873、0.786、0.830、0.971。结论3D-ASL联合IVIM鉴别放射性脑损伤和脑胶质瘤术后复发具有重要临床价值,可为临床治疗提供依据。Objective To explore the application of three-dimensional arterial spin labeling(3D-ASL) and intravoxel incoherent motion(IVIM)in postoperative recurrence and radiation brain injury of high-grade glioma.Methods Retrospective analysis of 60 patients with high-grade brain glioma was conducted from January2018 to September 2022.They were divided into recurrence group(n=23,postoperative recurrence)and injury group(n=37,radiation brain injury)according to the follow-up results or the results of the second operation.All patients underwent 3D-ASL and IVIM examinations.The diagnostic efficacy of 3D-ASL and IVIM was analyzed by ROC curve.Results D^(*)(2.46±0.58)10^(-3)mm/s,f(0.59±0.17),rCBF(3.06±0.96)and CBF(26.79±3.48)in the recurrence group were higher than those in the injury group(P<0.05).The AUC of D^(*),f,r CBF,CBF and the combination of four items in differentiating recurrence and radiation-induced brain injury after glioma surgery were 0.834,0.873,0.786,0.830 and 0.971,respectively.Conclusion 3D-ASL combined with IVIM has important clinical value in differentiating radiation brain injury and recurrence of brain glioma after operation,which can provide basis for clinical treatment.

关 键 词：脑胶质瘤 三维动脉自旋标记 体素内不相干运动 复发 放射性脑损伤 

分 类 号：R730.264[医药卫生—肿瘤]