动态增强MR联合酰胺质子转移成像检测对脑肿瘤诊断及分级的临床价值  

The Clinical Value of Dynamic Contrast Enhanced MRI Combined with Amide Proton Transfer Imaging Detection in the Diagnosis and Grading of Brain Tumors

作　　者：许跃根[1] 郑顺勇 Xu Yuegen;Zheng Shunyong(Zhangzhou Municipal Hospital of Fujian Province,Zhangzhou Fujian 363000,China)

机构地区：[1]福建省漳州市医院,福建漳州363000

出　　处：《医疗装备》2024年第19期1-4,9,共5页Medical Equipment

摘　　要：目的探讨动态增强MR(DCE-MR)联合酰胺质子转移成像(APT)检测对脑肿瘤诊断及分级的临床效能。方法选取2020年6月至2023年6月医院收治的40例脑胶质瘤患者为试验组,以同期收治的24例颅内良性肿瘤患者为对照组。对所有患者均行DCE-MR和APT扫描,比较两组影像学表现及肿瘤实质区的平均APT(mAPT)、平均容积转运常数(mKtrans)、血管外细胞外间隙容积比(Ve)图,分析各指标对脑胶质瘤诊断及分级的临床效能。结果脑胶质瘤DCE-MR图像显示,低级别脑胶质瘤影像学表现为长T1、T2,肿瘤大小、位置等分布较均衡,坏死部位较少见;15例低级别脑胶质瘤患者中3例出现轻度增强改变,12例未出现增强改变;高级别脑胶质瘤多以长T1、长T2为主的混杂信号为主,信号分布不均;25例高级别脑胶质瘤患者中22例出现显著增强改变,3例未出现任何增强改变。脑胶质瘤APT图像显示,脑白质信号正常以绿色为主;高级别脑胶质瘤表现为红、黄色高信号为主的异常信号,局部病灶密度增加,血液供应丰富在APT图像上也呈现高信号;高级别脑胶质瘤患者中3例无强化病例的胶质瘤核心区域在APT图像上呈现高信号;低级别脑胶质瘤在APT图像上为淡黄色-绿色的低信号改变,肿瘤中心区域没有或仅有轻微APT增强改变。试验组m APT、mK^(trans)、V_(e)水平高于对照组,差异有统计学意义(P<0.05);m APT、mK^(trans)、V_(e)及联合检测诊断脑胶质瘤的受试者工作特征(ROC)曲线下面积(AUC)分别为0.769、0.820、0.670、0.872,差异有统计学意义(P<0.05)。40例脑胶质瘤患者经病理确诊分为低级别组(15例)与高级别组(25例),低级别组的mAPT、mK^(trans)、V_(e)水平低于高级别组,差异有统计学意义(P<0.05);mAPT、mK^(trans)、V_(e)及联合检测诊断脑胶质瘤分级的AUC分别为0.877、0.864、0.851、0.941,差异有统计学意义(P<0.05)。结论DCE-MR联合APT检测可用于胶质瘤的临床�Objective To investigate the clinical efficacy of dynamic contrast enhanced MR(DCE-MR)combined with amide proton transfer(APT)imaging detection in the diagnosis and grading of brain tumors.Methods With the selection of 40 patients with brain glioma admitted to the hospital from June 2020 to June 2023 as the experimental group,and 24 patients with intracranial benign tumors during the same period as the control group,DCE-MR and APT scans were performed on all patients.The imaging findings and mean APT(mAPT),mean volume transfer constant(mK^(trans)),and extravascular extracellular volume(V_(e))maps of the tumor parenchyma were compared between the two groups to analyze the clinical efficacy of each indicator in the diagnosis and grading of brain glioma.Results DCE-MR images of glioma showed that the imaging features of low-grade gliomas were long T_(1) and T_(2),with a relatively balanced distribution of tumor size and location,and fewer necrotic sites;Among 15 cases of low-grade gliomas,3 cases showed mild enhancement changes,while 12 cases did not show enhancement changes;High-grade gliomas were mainly characterized by mixed signals of long T_(1) and long T_(2),with uneven signal distribution;Among 25 cases of high-grade gliomas,22 cases showed significant enhancement changes,while 3 cases did not show any enhancement changes.APT images of glioma showed that the normal white matter signals were mainly green;High-grade gliomas showed abnormal signals mainly with red and yellow high signals.Increased local lesion density and abundant blood supply also showed high signals in APT images;In high-grade glioma,the core region of glioma in 3 cases without enhancement showed high signal on APT image;The low grade glioma showed light yellow-green low signal changes on APT images,with no or only slight APT enhancement in the central region of the tumor.The levels of mAPT,mK^(trans),and V_(e) in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05);The a

关 键 词：动态增强MR 酰胺质子转移成像 脑胶质瘤 分级 临床效能 

分 类 号：R737.9[医药卫生—肿瘤]