3D ASL技术结合DWI在脑胶质瘤术前诊断分级中的评估价值  

Assessment value of 3D ASL technology combined with DWI in preoperative diagnosis and grading of brain glioma

作　　者：李文华[1] 李伟[2] 刘文波[1] 马瑞芳[1] 辛丽琴[1] 苗田慧 刘浩[1] 杨金花[1] LI Wen-hua;LI Wei;LIU Wen-bo(Department of Imaging,Ordos Central Hospital,Ordos Inner Mongolia 017000,China;Imaging Center,The Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot Inner Mongolia 010000,China)

机构地区：[1]鄂尔多斯市中心医院影像科,内蒙古鄂尔多斯017000 [2]内蒙古医科大学第二附属医院影像中心,内蒙古呼和浩特010000

出　　处：《临床和实验医学杂志》2023年第22期2435-2439,共5页Journal of Clinical and Experimental Medicine

基　　金：内蒙古自治区科技计划项目(编号:2019GG053);内蒙古医科大学“科技百万工程”[编号:YKD2020KJBW(LH)060]。

摘　　要：目的探究三维动脉自旋标记成像(3D ASL)技术结合弥散加权成像(DWI)在脑胶质瘤术前诊断分级中的评估价值。方法回顾性选取2017年3月至2023年4月在鄂尔多斯市中心医院进行诊疗的65例脑胶质瘤患者的临床影像学检查资料,所有入组患者均进行3D ASL及DWI检查,根据患者活检或手术后病理检验结果对患者进行分组,其中35例低级别脑胶质瘤患者纳入低级别组,30例高级别脑胶质瘤患者纳入高级别组。分析两组患者术前3D ASL[总脑血流量(TBF)、局部总脑血流量(rTBF)、健侧脑白质血流(CBF)、相对脑血流量(rCBF)]及DWI[表观弥散系数(ADC)、相对ADC(rADC)]检查结果的异同,探究3D ASL及DWI技术对在术前分级中的评估价值。结果高级别组的3D ASL检查CBF、rCBF、TBF、rTBF值分别为88.11±13.26、6.22±1.98、2.88±0.83、4.23±0.98,均高于低级别组(60.11±15.56、3.77±1.22、1.45±0.21、1.82±0.14),差异均有统计学意义(P<0.05)。以患者术后病理学检验结果为金标准,3D ASL诊断脑胶质瘤高低级别的准确率为84.62%,敏感度为73.33%,特异度为94.29%,高级别预测值为91.67%,低级别预测值为80.49%。高级别组ADC、rADC值分别为1.05±0.22、1.33±0.33,均低于低级别组(1.22±0.26、1.77±0.42),差异均有统计学意义(P<0.05)。以患者术后病理学检验结果为金标准,DWI诊断脑胶质瘤高低级别的准确率为86.15%,敏感度为80.00%,特异度为91.43%,高级别预测值为88.89%,低级别预测值为84.21%;3D ASL联合DWI诊断脑胶质瘤高级别的准确率为87.69%,敏感度为86.67%,特异度为88.57%,高级别预测值为86.67%,低级别预测值为88.57%。3D ASL、DWI分别及联合检查诊断脑胶质瘤患者术前高级别的曲线下面积(AUC)值分别为0.788、0.802、0.876。结论术前3D ASL技术结合DWI对脑胶质瘤患者病情诊断分级的准确率较高,具有较高的应用价值,值得临床推广。Objective To explore the evaluation value of 3D arterial spin labeling(3D ASL)combined with magnetic resonance perfusion imaging(DWI)in the preoperative diagnosis and grading of brain glioma.Methods The clinical imaging data of 65 patients with brain glioma who underwent diagnosis and treatment in Ordos Central Hospital from March 2017 to April 2023 were retrospectively selected.All patients underwent 3D ASL and DWI examinations.According to the histological examination results of patient biopsies or postoperative pathology,35 cases of low-grade brain glioma patients were included in the low-grade group,and 30 cases of high-grade brain glioma patients were included in the high-grade group.The similarities and differences in the results of preoperative 3D ASL and DWI examinations were analyzed to explore the evaluation value of 3D ASL[total cerebral blood flow(TBF),local total cerebral blood flow(rTBF),contralateral white matter blood flow(CBF),relative cerebral blood flow(rCBF)]and DWI[apparent dispersion coefficient(ADC),relative ADC(rADC)]in preoperative grading.Results The 3D ASL values of CBF,rCBF,TBF,and rTBF in the high-level group were 88.11±13.26,6.22±1.98,2.88±0.83,and 4.23±0.98,respectively,which were higher than those in the low-level group(60.11±15.56,3.77±1.22,1.45±0.21,and 1.82±0.14),and the differences were statistically significant(P<0.05).Using postoperative pathological examination results as the gold standard,the accuracy of 3D ASL for diagnosing high-and low-grade gliomas was 84.62%,sensitivity was 73.33%,specificity was 94.29%,and the predictive value for high-grade gliomas was 91.67%,while the predictive value for low-grade gliomas was 80.49%.The ADC and rADC values of the advanced group were 1.05±0.22 and 1.33±0.33,respectively,which were lower than those of the low-grade group(1.22±0.26 and 1.77±0.42),and the differences were statistically significant(P<0.05).Using postoperative pathological examination results as the gold standard,the accuracy of DWI for diagnosing high-and lo

关 键 词：三维动脉自旋标记成像 磁共振灌注成像 脑胶质瘤 术前诊断分级 

分 类 号：R739.41[医药卫生—肿瘤]