磁共振灌注加权成像联合扩散加权成像鉴别脑胶质瘤分级的效能分析  

Efficiency Analysis of Magnetic Resonance Perfusion Weighted Imaging combined with Diffusion Weighted Imaging in Distinguishing the Grading of Gliomas

作　　者：郭松 宋朝晖[1] 张首宁[2] GUO Song;SONG Chaohui;ZHANG Shouning(Zhengzhou Third People's Hospital,Zhengzhou Henan 450000)

机构地区：[1]郑州市第三人民医院,河南郑州450000 [2]河南省肿瘤医院,河南郑州450000

出　　处：《医学临床研究》2024年第6期871-874,共4页Journal of Clinical Research

摘　　要：【目的】探讨磁共振灌注加权成像(PWI)联合扩散加权成像(DWI)鉴别脑胶质瘤分级的效能。【方法】回顾性分析2021年10月至2022年10月两院收治的经手术病理确诊的脑胶质瘤患者70例(低级别脑胶质瘤40例,高级别脑胶质瘤30例),比较肿瘤实质区、瘤周水肿区与对侧相应正常脑实质的局部脑血流量(rCBF)和表观扩散系数(ADC),比较不同级别脑胶质瘤患者肿瘤实质区和瘤周水肿区相对rCBF(rrCBF)和相对ADC(rADC)。绘制受试者工作特征(ROC)曲线评价rrCBF、rADC单独及联合鉴别脑胶质瘤分级的效能。【结果】肿瘤实质区rCBF高于瘤周水肿区和正常脑实质(P<0.05),ADC低于瘤周水肿区和正常脑实质(P<0.05);瘤周水肿区rCBF高于正常脑实质(P<0.05),ADC低于正常脑实质(P<0.05)。低级别脑胶质瘤患者肿瘤实质区rrCBF低于高级别脑胶质瘤患者(P<0.05),rADC高于高级别脑胶质瘤患者(P<0.05)。低级别脑胶质瘤患者瘤周水肿区rrCBF低于高级别脑胶质瘤患者(P<0.05),rADC与高级别脑胶质瘤患者比较,差异无统计学意义(P>0.05)。ROC曲线分析结果显示:rrCBF、rADC对脑胶质瘤分级均有一定鉴别效能,曲线下面积分别为0.898、0.870,敏感度分别为0.867、0.900,特异度分别为0.800、0.775;两项联合鉴别脑胶质瘤分级的曲线下面积为0.954,敏感度为0.933,特异度为0.975。【结论】PWI、DWI对脑胶质瘤分级均有一定鉴别效能,两者联合鉴别效能更高,值得临床积极推广。【Objective】To explore the efficacy of magnetic resonance perfusion weighted imaging(PWI)combined with diffusion weighted imaging(DWI)in distinguishing the grading of gliomas.【Methods】A retrospective analysis was conducted on 70 patients with surgically and pathologically confirmed gliomas admitted to two hospitals from October 2021 to October 2022(40 cases of low-grade gliomas and 30 cases of high-grade gliomas).The regional cerebral blood flow(rCBF)and apparent diffusion coefficient(ADC)of the tumor parenchyma area,peritumoral edema area,and corresponding normal brain parenchyma on the opposite side were compared,and the relative rCBF(rrCBF)and relative ADC(rADC)of the tumor parenchyma area and peritumoral edema area of patients with different grades of gliomas were compared.The Receiver Operating Characteristic(ROC)curve was drawn to evaluate the efficacy of rrCBF and rADC alone and in combination in distinguishing the grading of gliomas.【Results】The rCBF in the tumor parenchyma area was higher than that in the peritumoral edema area and normal brain parenchyma(P<0.05),while the ADC was lower than that in the peritumoral edema area and normal brain parenchyma(P<0.05);The rCBF in the peritumoral edema area was higher than that in the normal brain parenchyma(P<0.05),and the ADC was lower than that in the normal brain parenchyma(P<0.05).The rrCBF in the tumor parenchyma of low-grade glioma patients was lower than that of high-grade glioma patients(P<0.05),and the rADC was higher than that of high-grade glioma patients(P<0.05).The rrCBF in the peritumoral edema area of low-grade glioma patients was lower than that of high-grade glioma patients(P<0.05),and there was no statistically significant difference in rADC compared to high-grade glioma patients(P>0.05).The ROC curve analysis results showed that both rrCBF and rADC had certain discriminative effects on the grading of gliomas,with areas under the curves of 0.898 and 0.870,sensitivity of 0.867 and 0.900,and specificity of 0.800 and 0.775,respectively

关 键 词：神经胶质瘤/影像诊断 脑肿瘤/影像诊断 弥散磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤]