MR动态磁敏感对比增强灌注成像鉴别脑胶质瘤复发与假性进展的应用研究  

MR Dynamicsusceptibility Contrat Perfusion Imaging in Discrimination between the Recurrence and Pseudoprogression in Glioma

作　　者：严君 徐瑾[2] 林慧慧 徐一文 Yan Jun;Xu Jin;Lin Hui-hui;Xu Yi-wen(Imaging Department of Suzhou Blue Cross Brain Hospital,Suzhou 215100,Jiangsu Province,China;Imaging Department of the Second Affiliated Hospital of Soochow University,Suzhou 215004,Jiangsu Province,China)

机构地区：[1]苏州蓝十字脑科医院影像科,江苏苏州215100 [2]苏州大学附属第二医院影像科,江苏苏州215004

出　　处：《中国CT和MRI杂志》2023年第10期8-10,22,共4页Chinese Journal of CT and MRI

摘　　要：目的 探讨3.0T动态磁敏感对比增强灌注成像(DSC-MRI)鉴别脑胶质瘤综合治疗后复发与假性进展(PP)的临床价值。方法 回顾性分析27例经手术切除后行同步放化疗的胶质瘤患者的DSC-MRI资料,勾画ROI并测量新增异常强化灶rCBV、rCBF、MTT、TTP这四个灌注参数,通过手术病理或随访将27例患者分为胶质瘤复发组与假性进展组。采用独立样本t检验对胶质瘤复发组和假性进展组各灌注参数进行统计分析;使用ROC曲线分析各灌注参数的诊断效能。结果 27例患者,18例为肿瘤复发,9例为假性进展。胶质瘤复发组的rCBV和rCB F值分别为2.56±1.26、和2.55±1.32,明显高于假性进展组的1.13±0.37和1.18±0.51,两组间差异具有统计学意义(t=4.42,P<0.05;t=2.99,P<0.05);胶质瘤复发组的MTT和TTP值分别为27.01±2.84和26.27±2.86,明显低于假性进展组的29.05±0.75和28.96±1.03 (t=-2.86,P<0.05;t=-3.56,P<0.05)。各灌注参数的ROC曲线分析显示,rCBV鉴别胶质瘤复发和假性进展的曲线下面积最大(0.901),敏感性和特异性分别为94.4%、88.9%。结论 DSC-MRI可以用于鉴别胶质瘤复发与假性进展,rCBV值对二者鉴别临床价值最高。Objective To evaluate the value of 3.0T MR dynamicsusceptibility contrat perfusion imaging(DSCMRI)in distinguishing pseudoprogression(PP)from the recurrence in glioma after comprehensive treatment.Methods 3.0T DSC-MRI examination were performed in 27 cases with glioma after surgery,chemotherapy and radiation therapy.The values of relative cerebral blood volume(rCBV),relative cerebral blood flow(rCBF),mean transit time(MTT),andtime-to-peak(TTP)were calculated in the newly developed abnormal enhancement by ROI.27 cases were divided into recurrence group and PP group by surgical pathology or follow-up.Independent sample t test was used to analyze the perfusion parameters of recurrence and PP groups.Receiver operating characteristic(ROC)curve was performed for evaluation of the sensitivity,specificity and AUC.Results 18 cases of recurrence and 9 cases of pseudoprogression were determined by histopathology or fllow-up.Recurrence group showed higher rCBV(2.56±1.26 vs.1.13±0.37)and(2.55±1.32 vs.1.18±0.51),when compared with PP group,the differences were statistically significant(t=4.42,P<0.05;t=2.99,P<0.05).The MTT and TTP values of recurrence group were 27.01±2.84 and 26.27±2.86,respectively,which were significantly lower than those of the PP group(29.0±0.75 and 28.96±1.03,respectively)(t=-2.86,P<0.05;t=-3.56,P<0.05).ROC curve showed the AUC value to diagnose recurrence and PP of rCBV was the highest(0.901),and the sensitivity and specificity were 94.4%and 88.9%.Conclusion DSC-MRI can be used to identify glioma recurrence and pseudoprogression,rCBV value has the most clinical significance.

关 键 词：磁共振灌注成像 胶质瘤 肿瘤复发 假性进展 

分 类 号：R445.2[医药卫生—影像医学与核医学]