胶质母细胞瘤术后复发的MRI诊断  

MRI Diagnosis of Postoperative Recurrence in Glioblastoma Multiforme

作　　者：鲁强[1] 杨瑞山[1] 王可 LU Qiang;YANG Rui-shan;WANG Ke(CT Magnetic resonance Imaging Room of Liaocheng Second People's Hospital(Liaocheng Second Hospital Affiliated to Shandong First Medical University),Liaocheng 252600,Shandong Province,China)

机构地区：[1]聊城市第二人民医院(山东第一医科大学附属聊城二院)CT磁共振室,山东聊城252600

出　　处：《中国CT和MRI杂志》2023年第6期8-10,共3页Chinese Journal of CT and MRI

基　　金：山东省医药卫生科技发展计划项目(2019WS103)。

摘　　要：目的探讨胶质母细胞瘤(GBM)术后复发的磁共振(MRI)诊断。方法回顾性选取2017年1月~2021年1月在我院收治的211例GBM患者作为研究对象,根据其经二次手术或于术后随访结果分为复发组(n=119)与未复发组(n=92)。均于术后完善MRI和弥散加权成像(DWI),收集术后6个月相关影像学资料,比较两组表观扩散系数(ADC)图像信号、ADC值、肿瘤强化部分残余体积与肿瘤强化部分切除程度。结果复发组主要以ADC低信号为主(P<0.05),未复发组以ADC高信号为主(P<0.05);复发组平均ADC值(ADC_(mean))、相对ADC值(rADC_(mean))、最小ADC值(ADC_(min))和最大ADC值(ADC_(max))均低于未复发组(P<0.05);复发组肿瘤强化部分残余体积高于未复发组(P<0.05),肿瘤强化部分切除程度低于未复发组(P<0.05);受试者工作曲线(ROC)分析显示,ADC_(mean)、rADC_(mean)、ADC_(min)和ADC_(max)预测GBM术后复发的AUC分别为0.701、0.722、0.777和0.672;肿瘤强化部分残余体积、肿瘤强化部分切除程度评估GBM术后复发的AUC分别为0.798和0.781。结论对GBM术后采用MRI技术进行分析对肿瘤复发预测效能较好,临床医师可根据患者情况进行定期MRI复查,检测ADC值、强化部分残余体积与肿瘤强化部分切除程度。Objective To explore the magnetic resonance imaging(MRI)diagnosis of postoperative recurrence in glioblastoma multiforme(GBM).Methods A total of 211 patients with GBM admitted to the hospital were retrospectively enrolled as the research objects between January 2017 and January 2021.According to the results of secondary surgery or postoperative follow-up,they were divided into recurrence group(n=119)and non-recurrence group(n=92).All underwent routine MRI scan,enhanced and diffusion weighted imaging(DWI)after surgery.The relevant imaging data were collected at 6 months after surgery.The image signals of apparent diffusion coefficient(ADC),ADC value,residual volume and resection degree of tumor enhancement part were compared between the two groups.Results The low signals and high signals of ADC were in the majority in recurrence group and nonrecurrence group,respectively(P<0.05).The _(mean) ADC value(ADC_(mean)),relative ADC value(rADC_(mean)),the _(min)imum ADC value(ADC_(min))and the _(max)imum ADC value(ADC_(max))in recurrence group were lower than those in non-recurrence group(P<0.05).The residual volume of tumor enhancement part in recurrence group was larger than that in non-recurrence group(P<0.05),and resection degree was lower than that in non-recurrence group(P<0.05).The receiver operating characteristic(ROC)curves analysis showed that AUC values of ADC_(mean),rADC_(mean),ADC_(min) and ADC_(max) for predicting postoperative recurrence of GBM were 0.701,0.722,0.777 and 0.672,respectively.AUC values of residual volume and resection degree of tumor enhancement part for predicting postoperative recurrence were 0.798 and 0.781,respectively.Conclusion MRI has certain predictive value for postoperative recurrence of GBM.Clinicians can regularly carry out MRI reexa_(min)ation according to patients’conditions to detect ADC value,residual volume and resection degree of tumor enhancement part.

关 键 词：胶质母细胞瘤 磁共振弥散成像技术 表观扩散系数 术后肿瘤复发 

分 类 号：R445.2[医药卫生—影像医学与核医学]