增强T2 FLAIR对增强T1WI鉴别原发性中枢神经系统淋巴瘤与胶质母细胞瘤的增量价值研究  

Incremental Value of Contrast-enhanced T2-FLAIR Over Contrast-enhanced T1WI in Differentiating Primary Central Nervous System Lymphoma from Glioblastoma

作　　者：梁泓中 周庆陆 陈夏宜 郭睿[1,3,4] 张学梅 肖运平 覃滢[1,3,4] LIANG Hongzhong;ZHOU Qinglu;CHEN Xiayi;GUO Rui;ZHANG Xuemei;XIAO Yunping;QIN Ying(Department of Radiology,Liuzhou People's Hospital,Guangxi Medical University,Liuzhou 545006,China;Graduate School,Guangxi University of Chinese Medicine;Liuzhou Molecular Imaging Laboratory;Guangxi Key Clinical Specialties of Medical Imaging;Department of Pathology,Liuzhou People's Hospital,Guangxi Medical University;Guangxi Key Laboratory of Clinical Disease Biotechnology Research)

机构地区：[1]广西医科大学附属柳州市人民医院放射科,柳州545006 [2]广西中医药大学研究生院 [3]柳州市分子影像实验室 [4]广西医学影像重点专科 [5]广西医科大学附属柳州市人民医院病理科 [6]广西临床疾病生物技术研究重点实验室

出　　处：《中国医学计算机成像杂志》2025年第1期14-19,共6页Chinese Computed Medical Imaging

基　　金：广西壮族自治区卫生健康委员会自筹经费课题(Z20190350,Z-B20221364);柳州市新世纪个十百人才工程专项基金;柳州市科技计划项目(2020NBAC0801,2022CAC0208)。

摘　　要：目的:探讨增强T2 FLAIR对增强T1WI鉴别原发性中枢神经系统淋巴瘤(PCNSL)和胶质母细胞瘤(GBM)的增量价值。方法:分析经临床和手术病理证实的22例PCNSL及48例GBM患者术前增强T1WI、增强T2 FLAIR图像。比较PCNSL组和GBM组在增强T1WI、增强T2 FLAIR上强化特征的差异。应用受试者工作特征(ROC)曲线下面积(AUC)和二元logistic回归分析单独使用和联合使用增强T1WI、增强T2FLAIR强化特征鉴别PCNSL和GBM的诊断效能。结果:2组在增强T1WI的强化比例和强化均匀度上均有统计学差异(P<0.05),在增强T2 FLAIR的边缘强化和中心强化上也均有统计学差异(P<0.05)。联合使用增强T1WI强化特征和增强T2 FLAIR强化特征的ROC曲线下面积(AUC)值显著高于单独使用增强T1WI强化特征、增强T2 FLAIR强化特征的AUC值(P<0.05)。结论:增强T2 FLAIR对增强T1WI鉴别PCNSL和GBM有一定增量价值。Purpose: To investigate the incremental value of contrast-enhanced(CE) T2-FLAIR over CE T1WI in differentiating primary central nervous system lymphoma(PCNSL) from glioblastoma(GBM). Methods: Twentytwo cases of PCNSL and 48 cases of GBM confirmed by clinical and surgical pathological results were analyzed for enhancement features on preoperative MRI CE T2-FLAIR. The differences in enhancement features on CE T1WI and CE T2-FLAIR between the PCNSL group and the GBM group were compared. The area under the receiver operating characteristic(ROC) curve(AUC) and binary logistic regression analysis were used to evaluate diagnostic efficiency of CE T1WI, CE T2-FLAIR enhancement characteristics, and their combination in distinguishing PCNSL from GBM.Results: There were statistically significant differences in the proportion enhancing and homogeneity of enhancement on CE T1WI between the two groups(P<0.05). There were statistically significant differences in peripheral rim enhancement and central enhancing foci on CE T2-FLAIR between the two groups(P<0.05). The AUC value obtained by combining the enhancement features on CE T1WI and CE T2-FLAIR was significantly higher than that obtained by using enhancement features either on CE T1WI or CE T2-FLAIR alone(P<0.05).Conclusion: CE T2-FLAIR has certain incremental value over CE T1WI in differentiating PCNSL from GBM.

关 键 词：原发性中枢神经系统淋巴瘤 胶质母细胞瘤 磁共振成像 对比剂 液体衰减反转恢复 

分 类 号：R445.2[医药卫生—影像医学与核医学]