磁共振脑灌注成像在鉴别颅内肿瘤性病变与非肿瘤性病变的应用研究  

Application research of magnetic resonance cerebral perfusion weighted imaging in differentiating intracranial neoplastic lesions from non-neoplastic lesions

作　　者：孙全余[1] 戴守平[1] 高天贶 栗付周 吕宝涛[1] 张玉松[1] SUN Quanyu;DAI Shouping;GAO Tiankuang;LI Fuzhou;LYU Baotao;ZHANG Yusong(Department of Imaging,Linyi People's Hospital,Shandong Province,Linyi 276000,China;Department of Health and Rehabilitation,Linyi People's Hospital,Shandong Province,Linyi 276000,China)

机构地区：[1]山东省临沂市人民医院影像科,山东临沂276000 [2]山东医学高等专科学校健康与康复系,山东临沂276000

出　　处：《中国当代医药》2024年第21期111-114,共4页China Modern Medicine

基　　金：国家级继续医学教育项目[2022-09-01-274(国)]。

摘　　要：目的探讨磁共振脑灌注成像鉴别颅内肿瘤性病变与非肿瘤性病变的价值。方法选取临沂市人民医院2020年2月至2024年2月收治并经病理证实的33例颅内肿瘤患者作为肿瘤组,患者均为星形细胞瘤,按照肿瘤级别分为低级别组(15例)及高级别组(18例),选取同期收治的40例颅内非肿瘤性病变患者作为对照组。经磁共振常规序列及脑灌注成像扫描后,计算出肿瘤的最大脑血流量(CBF)最大脑血容量(CBV)。比较各组别的CBF、CBV值,分析影像学表现。结果肿瘤组中,高级别组的CBF、CBV值均高于低级别组,差异有统计学意义(P<0.05);肿瘤组的CBF、CBV值高于对照组,差异有统计学意义(P<0.05);图像显示,星形细胞瘤、脑炎及脱髓鞘患者的CBF、CBV值高于对侧的正常组织,可见明显高灌注表现。结论当星形细胞瘤表现不典型时,可行脑灌注成像检查,以期提高颅内肿瘤性病变及非肿瘤性病变诊断符合率。出现灌注明显升高时,应考虑肿瘤性病变。Objective To investigate the value of magnetic resonance cerebral perfusion imaging in differentiating intracra-nial neoplastic lesions from non-neoplastic lesions.Methods A total of 33 patients with intracranial tumors confirmed by pathology admitted to Linyi People's Hospital from February 2020 to February 2024 were selected as the tumor group.All patients were astrocytoma,and they were divided into low-grade group(15 cases)and high-grade group(18 cases)according to tumor grade.A total of 40 patients with non-neoplastic intracranial lesions were selected as control group.The maximum cerebral blood flow(CBF)and the maximum cerebral blood volume(CBV)of the tumor were calculated by conventional MRI sequence and cerebral perfusion weighted imaging.The CBF and CBV values of each group were compared,and the imaging findings were analyzed.Results In the tumor group,the CBF and CBV values of the high-grade group were higher than those of the low-grade group,and the differences were statistically significant(P<0.05).The CBF and CBV values of tumor group were higher than those of control group,and the dfferences were statistically significant(P<0.05).The images showed that the CBF and CBV values of the patients with astrocytoma,encephalitis and demyelination were higher than those of the contralateral normal tissue,indicating obvious hyperperfusion manifestations.Conclusion When the astrocy-toma is atypical,cerebral perfusion weighted imaging is feasible to improve the diagnostic coincidence rate of intracranial neoplastic lesions and non-neoplastic lesions.When there is a significant increase in perfusion,neoplastic lesions should be considered.

关 键 词：磁共振成像 灌注成像 颅内肿瘤 非肿瘤性病变 鉴别诊断 

分 类 号：R814[医药卫生—影像医学与核医学]