MRI图像灰度值在评估小脑脑桥角区肿瘤特征及相关功能中的应用价值  

The application role of MRI image grayscale value in evaluating the tumor characteristics and related functions of patients with cerebellopontine angle tumors

作　　者：杨雪[1] 吴宇[1] 陈谦学[1] Yang Xue;Wu Yu;Chen Qianxue(Department of Neurosurgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院神经外科,武汉430060

出　　处：《中华神经外科杂志》2025年第2期170-174,共5页Chinese Journal of Neurosurgery

摘　　要：目的探讨MRI图像灰度值在评估小脑脑桥角(CPA)区肿瘤特征及相关功能中的应用价值。方法回顾性收集2019年6月至2023年6月武汉大学人民医院神经外科手术治疗的94例CPA区肿瘤患者的临床资料,选取术前头颅增强MRI T1矢状位图像,并采用ImageJ软件勾画肿瘤区域后获得肿瘤面积、最大灰度值、最小灰度值及平均灰度值。术后根据患者肿瘤病理学分型分为神经鞘瘤(54例)、脑膜瘤(26例)、表皮样囊肿(10例)、其他肿瘤[胶质母细胞瘤(1例)、转移瘤(1例)、脊索瘤(2例)];采用House-Brackmann(H-B)分级评估神经鞘瘤患者面神经功能,并计算术后面神经功能下降等级(即术后与术前H-B分级的差值)。采用Pearson或Spearman相关系数评估MRI图像灰度值与肿瘤面积、面神经功能的相关关系。采用方差分析不同病理学分型间MRI图像灰度值的差异。结果94例患者的肿瘤面积中位数为5.04(0.40~15.99)cm^(2),其中神经鞘瘤为(5.59±0.49)cm^(2),脑膜瘤为(5.12±0.61)cm^(2),表皮样囊肿为(2.54±0.53)cm^(2),胶质母细胞瘤为0.40 cm^(2),转移瘤为2.91 cm^(2),脊索瘤为4.25和6.18 cm^(2)。94例患者肿瘤的最大灰度值、最小灰度值、平均灰度值分别为225.13±3.88、58.44±4.07、172.78±5.48。54例神经鞘瘤患者肿瘤的最大灰度值、最小灰度值、平均灰度值分别为227.60±36.41、49.17±32.00、170.00±47.97。54例神经鞘瘤患者术后H-B分级Ⅰ级17例,Ⅱ级14例,Ⅲ级16例,Ⅳ级6例,另1例患者术后昏迷,未行H-B分级评估;术后28例患者的H-B分级下降(下降等级为1级10例,2级13例,3级5例),1例改善(下降等级为-1级),24例无改变(下降等级为0级)。相关性分析结果显示,CPA区肿瘤的最小灰度值与肿瘤面积(r=-0.28,P=0.007)呈直线负相关关系;而神经鞘瘤患者肿瘤的不同灰度值与其面神经功能均无明显相关性(均P>0.05)。方差分析结果显示,不同病理学分型间MRI图像灰度值的差异均无统�ObjectiveTo investigate the application role of MRI image grayscale value in evaluating the tumor features and related nerve function of patients with cerebellopontine angle(CPA)tumors.MethodsA retrospective analysis was performed on the clinical data of patients with CPA tumors who underwent surgical treatment in the Department of Neurosurgery,Renmin Hospital of Wuhan University from June 2019 to June 2023.We selected preoperative head enhanced MRI T1 sagittal images,and used ImageJ software to delineate the tumor area to obtain tumor area,maximum grayscale value,minimum grayscale value,and average grayscale value.According to the pathological classification of the patients′tumors after surgery,they were divided into schwannoma(54 cases),meningioma(26 cases),epidermoid cyst(10 cases)and other tumors[glioblastoma(1 case),metastatic tumor(1 case),and chordoma(2 cases)].House-Brackmann(H-B)grading was used to evaluate the facial nerve function of schwannoma patients and calculate the level of neurological decline(i.e.the difference between postoperative and preoperative H-B grades).Pearson or Spearman correlation coefficients was used to evaluate the correlation relationship among MRI image grayscale values,tumor areas and facial nerve function of the patients.Analysis of variance was used to investigate the differences in MRI image grayscale values between different pathological subtypes of tumors.ResultsAccording to the pathological classification of tumors,the median area of tumors in 94 patients was 5.04(0.40-15.99)cm^(2).Among them,schwannoma was 5.59±0.49 cm^(2),meningioma was 5.12±0.61 cm^(2),epidermoid cyst was 2.54±0.53 cm^(2),glioma was 0.40 cm^(2),metastatic cancer was 2.91 cm^(2),and spinal cord tumors were 4.25 cm^(2) and 6.18 cm^(2).The maximum grayscale value,minimum grayscale value and average grayscale value,of tumors in 94 patients were 225.13±3.88,58.44±4.07,and 172.78±5.48 respectively.The maximum grayscale value,minimum grayscale value,and average grayscale value of tumors in 54 schwann

关 键 词：小脑脑桥角 脑肿瘤 磁共振成像 面神经功能 图像灰度值 

分 类 号：R73[医药卫生—肿瘤]