酰胺质子转移成像、三维动脉自旋标记成像鉴别诊断胶质瘤复发与治疗后改变的应用  

The clinical application of amide proton transfer imaging and three-dimensional arterial spin labeling imaging in differential diagnosis of glioma recurrence from post-treatment changes

作　　者：李双红 张金环 陈玲[1] 李涛[1] LI Shuanghong;ZHANG Jinhuan;CHEN Ling;LI Tao(Department of Medical Imaging,the Fourth Affiliated Hospital of Guangxi Medical University,Liuzhou 545007,China)

机构地区：[1]广西医科大学第四附属医院医学影像科,广西柳州545007

出　　处：《实用放射学杂志》2023年第10期1565-1568,共4页Journal of Practical Radiology

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210919);柳州市科技计划项目(2021CBC0128)。

摘　　要：目的探讨酰胺质子转移(APT)成像与三维动脉自旋标记(3D-ASL)成像技术所获得的定量参数在鉴别胶质瘤复发与治疗后改变中的诊断效能。方法纳入在影像学随访中出现术区强化灶或远处新增强化灶/液体衰减反转恢复(FLAIR)高信号灶的27例胶质瘤术后患者(共35个病灶),经二次手术后病理或临床上通过纵向MRI随访(>3个月)确定为复发16例,治疗后改变11例,行常规头颅MRI及APT、3D-ASL检查。测量强化区及健侧区的脑血流量(CBF)值与APT值。对各组参数运用独立样本t检验进行比较,采用受试者工作特征(ROC)曲线分析诊断效能。结果胶质瘤术后复发与治疗后改变的相对脑血流量(rCBF)值分别为2.02、0.77,差异有统计学意义(P<0.05),平均APT(APTmean)值则分别为3.09%、1.77%,差异有统计学意义(P<0.05);rCBF、APTmean联合应用诊断时,所对应的曲线下面积(AUC)为0.95,敏感度为91.3%,特异性为91.7%。结论APT和3D-ASL所获取的定量参数值有利于鉴别胶质瘤复发与治疗后的改变,两者联合应用有助于提高鉴别诊断准确率。Objective To investigate the diagnostic efficacy of quantitative parameters obtained by amide proton transfer(APT)imaging and three-dimensional arterial spin labeling(3D-ASL)imaging in differentiating glioma recurrence from post-treatment changes.Methods Twenty-seven patients(35 lesions in total)with postoperative glioma who had enhanced lesions in the surgical area or new distant enhanced lesions/fluid attenuated inversion recovery(FLAIR)hyperintense lesions in the follow-up imaging were included in this study.Of 27 patients,there were 16 patients with recurrence by secondary postoperative pathology or clinical longitudinal MRI follow-up(more than 3 months),and 11 patients with changed lesions after treatment.Routine cranial MRI,APT and 3D-ASL were performed on all patients.Cerebral blood flow(CBF)and APT were measured in the enhanced area and contralateral area.The parameters of each group were compared by independent sample t test,and the diagnostic performance was analyzed by receiver operating characteristic(ROC)curve.Results There were statistically significant differences in relative cerebral blood flow(rCBF)values of postoperative recurrence with 2.02 and change after treatment with 0.77 in glioma patient(P<0.05).Mean APT(APTmean)values were 3.09% and 1.77%,respectively,with statistically significant differences between the two groups(P<0.05).The area under the curve(AUC)of combination rCBF with APTmean value was 0.95,the sensitivity was 91.3%,and the specificity was 91.7%,respectively.Conclusion The quantitative parameters obtained by APT and 3D-ASL are favorable for discriminating the recurrence of glioma from the change after treatment,and the combined application of both helps to improve the accuracy of differential diagnosis.

关 键 词：神经胶质瘤 肿瘤复发 酰胺质子转移成像 三维动脉自旋标记成像 

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