脑转移瘤伽玛刀后复发和放射性脑坏死的磁共振灌注成像鉴别诊断  

Perfusion-weighted imaging(PWI)in differentiating recurrent brain metastases after gamma knife treatment from delayed cerebral necrosis treatment

作　　者：董海波[1] 戴嘉中[2] 沈天真[2] 徐海东[1] 俞振浩[1] 缪光胜[1] 

机构地区：[1]宁波市医疗中心李惠利医院放射科,浙江宁波315040 [2]复旦大学华山医院放射科,上海200032

出　　处：《中国临床医学影像杂志》2003年第5期306-309,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨磁共振灌注成像(PWI)对脑转移瘤伽玛刀后复发和放射性脑坏死鉴别诊断价值。方法:21例经伽玛刀治疗的脑转移瘤患者和6例病史明确的放射性脑坏死,均行PWI。结果:前21例经手术证实,18例为脑转移瘤,3例放射性脑坏死,PWI定性诊断正确。18例脑转移瘤的rCBV值均升高,肿瘤最大rCBV比率为6.04±2.86,健侧为3.16±0.93(P<0.01);肿瘤MTT比率为1.49±0.58。9例放射性脑坏死rCBV值均降低,病灶最大rCBV比率为2.02±1.36,健侧为4.30±1.22(P<0.05);病灶MTT比率为1.08±0.14。结论:PWI对脑转移瘤伽玛刀后复发和放射性脑坏死鉴别有重要价值。Objective:To evaluate perfusion-weighted imaging(PWI)in differentiating recurrent brain metastases after gam-ma knife treatment from delayed cerebral necrosis.Materials and Methods:21patients who had clinical and CT,MRI changes that suggested a diagnosis of delayed cerebral necrosis or recurrent brain metastases after gamma knife treatment and6patients who had a clear clinical diagnosis of delayed cerebral necrosis underwent PWI.Results:Of the former21cases who proved by surgicopathology,18cases were metastases,3cases were delayed cerebral necrosis,their etiologic diagnoses of PWI were correct.PWI in18cases with brain metastases exhibited increased rCBV.The ratios of maximum rCBV of the lesions were6.04±2.86,of the normal sides were3.16±0.93(P<0.01).The ratios of MTT of the tumors were1.49±0.58.PWI in9cases with delayed cerebral necrosis appeared decreased rCBV(P<0.01),the ratios of maximum rCBV of the lesions were2.02±1.36,of the healthy sides were4.30±1.22(P<0.05),The ratios of MTT of the lesions were1.08±0.14.Conclusion:PWI is positively claimed for differentiating recurrent brain metastases after gamma knife treatment from delayed cerebral necrosis.

关 键 词：脑肿瘤 肿瘤转移 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]