多模态磁共振在颅脑单发转移瘤与高级别胶质瘤鉴别诊断中的价值  

Value of multimodal magnetic resonance imaging in differential diagnosis of single brain metastasis and high-grade glioma

作　　者：廖建 阮玖根 肖琼 LIAO Jian;RUAN Jiugen*;XIAO Qiong(Imaging Center,Xinyu People's Hospital,Xinyu,Jiangxi,338000,China)

机构地区：[1]新余市人民医院影像中心,江西新余338000

出　　处：《当代医学》2024年第17期108-112,共5页Contemporary Medicine

摘　　要：目的探讨多模态磁共振在颅脑单发转移瘤与高级别胶质瘤鉴别诊断中的价值。方法选取2019年1月至2022年12月新余市人民医院收治的24例手术病理诊断为颅脑单发转移瘤患者作为颅脑转移瘤组,36例高级别胶质瘤患者作为高级别胶质瘤组,两组均接受多模态磁共振检查。比较两组多模态磁共振影像学特征、多模态磁共振参数[瘤体最大直径、瘤体与瘤周表观弥散系数(apparent diffusion coefficient,ADC)值、脑血流量(cerebral blood flow,CBF)、肿瘤实质区相对脑血流量值(relative cerebral blood flow,rCBF)、瘤周水肿区rCBF、胆碱(choline,Cho)/肌酸(creatinine,Cr)、N-乙酰天门冬氨酸(N-acetyl aspartate,NAA)/Cr、Cho/NAA],采用受试者工作特征(receiver operating characteristic,ROC)曲线分析多模态磁共振对颅脑单发转移瘤与高级别胶质瘤的鉴别诊断价值。结果高级别胶质瘤组瘤灶形态不规则、强化方式为花环样占比均高于脑转移瘤组,差异有统计学意义(P<0.05)。高级别胶质瘤组肿瘤实质区rCBF、Cho/Cr、Cho/NAA均高于脑转移瘤组,瘤体ADC值、瘤体rADC、NAA/Cr均低于脑转移瘤组,差异有统计学意义(P<0.05)。ROC曲线分析显示,多模态磁共振参数指标中瘤体ADC值、肿瘤实质区rCBF、Cho/NAA三者联合检测诊断高级别胶质瘤的曲线下面积(area under the curve,AUC)高于单项检测(P<0.05)。结论多模态磁共振对颅脑单发转移瘤与高级别胶质瘤具有较高的诊断价值。Objective To explore the value of multimodal magnetic resonance imaging in differential diagnosis of single brain metastasis and high-grade glioma.Methods 24 patients with single brain metastases admitted to Xinyu People's Hospital from January 2019 to December 2022 were selected as the brain metastasis group and 36 patients with high-grade gliomas were selected as the high-grade glioma group,both groups underwent multimodal magnetic resonance imaging examination.The multimodal magnetic resonance imaging features and parameters(maximum tumor diameter,apparent diffusion coefficient[ADC]values of tumor body and tumor periphery,relative cerebral blood flow[rCBF]in tumor parenchyma,rCBF in tumor edema area,choline[Cho]/creatinine[Cr],N-acetyl aspartate[NAA]/Cr and Cho/NAA)were compared between the two groups,the receiver operating characteristic(ROC)curve was used to evaluate the value of multimodal magnetic resonance imaging in differential diagnosis of single brain metastasis and high-grade glioma.Results The proportions of irregular tumorsand garland-shaped enhancement in the high-grade glioma group were higher than those in the brain metastasis group,and the differences were satistically significant(P<0.05).The rCBF in tumor edema area,Cho/Cr and Cho/NAA in the high-grade glioma group were higher than those in the brain metastasis group,the ADC value and rADC of tumor body,NAA/Cr were lower than those in the brain metastasis group,and the differences were satistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of combination of the ADC value of tumor body,rCBF in tumor parenchyma and Cho/NAA in multimodal magnetic resonance imaging parameters for diagnosing high-grade glioma was higher than single assay(P<0.05).Conclusion Multimodal magnetic resonance imaging has high value in the differential diagnosis of single brain metastasis and high-grade glioma.

关 键 词：颅脑单发转移瘤 高级别胶质瘤 多模态磁共振 诊断 

分 类 号：R739.41[医药卫生—肿瘤]