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  本文關鍵詞： 膠質瘤 動態(tài)對比增強灌注成像 動態(tài)磁敏感增強灌注成像　出處：《第三軍醫(yī)大學學報》2015年07期 　論文類型：期刊論文

【摘要】：目的定量分析T1加權動態(tài)對比增強成像(DCE-MRI)中的參數(shù)(Ktrans、Ve)和T*2加權動態(tài)磁敏感增強灌注成像(DSC-MRI)中的參數(shù)(r CBV、r CBF)與腫瘤病理分級的相關性,比較DCE-MRI及DSC-MRI參數(shù)在腦膠質瘤分級診斷中的價值。方法病理證實的85例腦膠質瘤患者,低級別膠質瘤36例,高級別膠質瘤49例。患者在術前行DCE-MRI成像或/和DSC-MRI成像,以相應后處理軟件獲得灌注參數(shù)值。采用單因素方差分析比較不同級別膠質瘤Ktrans與Ve值及r CBV與r CBF值與腫瘤病理分級的差異,應用Pearson相關系數(shù)分析Ktrans、Ve值及r CBV、r CBF值與膠質瘤級別之間的相關性。應用ROC曲線分析獲得Ktrans、Ve值及r CBV與r CBF值鑒別不同級別膠質瘤的最佳閾值及其敏感性和特異性。結果高級別膠質瘤的平均Ktrans及Ve值均顯著高于低級別膠質瘤[分別為(0.157±0.177)/min-1vs(0.029±0.020)/min-1;(0.601±0.246)vs(0.118±0.062),P0.01]。當Ktrans=0.055/min-1時其診斷敏感性及特異性分別為89.7%和90.5%,當Ve=0.343時其診斷敏感性及特異性分別為86.2%和85.7%。高級別膠質瘤的平均r CBV及r CBF值均顯著高于低級別膠質瘤[(2.649±1.351)vs(1.480±0.391);(2.427±1.248)vs(1.377±0.545),P0.01]。當r CBV=2.043時其診斷敏感性及特異性分別95.2%和92.9%,當r CBF=1.886時其診斷敏感性及特異性分別為85.7%和85.7%。結論 Ktrans與Ve值,r CBV與r CBF值用于腦膠質瘤分級均具有較強相關性,而r CBV是敏感性及特異性最高的參數(shù),其次是Ktrans、Ve和r CBF。
[Abstract]:Objective to quantitatively analyze the parameters of Ktrans in T1-weighted dynamic contrast enhanced imaging (DCE-MRI). The correlation between the parameters of dynamic magnetic sensitivity perfusion imaging (DSC-MRI) and the pathological grade of tumor was found in Veg and TX 2 weighted dynamic magnetic sensitivity enhanced perfusion imaging (DSC-MRI). To compare the value of DCE-MRI and DSC-MRI parameters in the grading diagnosis of glioma. Methods 85 patients with glioma and 36 patients with low grade glioma were confirmed by pathology. 49 cases of high grade glioma were performed DCE-MRI imaging or / and DSC-MRI imaging before operation. The perfusion parameters were obtained by the corresponding post-processing software. The differences between Ktrans and ve values, r CBV and r CBF values and pathological grade of gliomas of different grade were compared by single factor variance analysis of variance (ANOVA). Pearson correlation coefficient was used to analyze the correlation between KtransVe value, r CBV CBF value and glioma grade, and Ktrans was obtained by ROC curve analysis. E value and r CBV and r. Results the average Ktrans and ve values of high-grade gliomas were significantly higher than those of low-grade gliomas. [0.157 鹵0.177% 路min -1 vs 0.029 鹵0.020% 路min -1; 0. 601 鹵0. 246VSD 0.118 鹵0. 062). When Ktrans=0.055/min-1, the diagnostic sensitivity and specificity were 89.7% and 90.5%, respectively. The diagnostic sensitivity and specificity were 86.2% and 85.7.The mean r CBV and r CBF values of high grade gliomas were significantly higher than those of low grade gliomas. [2.649 鹵1.351 鹵1.480 鹵0.391m; 2.427 鹵1.248 VSD 1.377 鹵0.545). When rCBV = 2.043, the diagnostic sensitivity and specificity were 95.2% and 92.9%, respectively. When r CBF = 1.886, the diagnostic sensitivity and specificity were 85.7% and 85.7 respectively. Conclusion Ktrans and ve values are significant. R CBV and r CBF were highly correlated with glioma grading, while r CBV was the most sensitive and specific parameter, followed by KtransVe and r CBF.
【作者單位】： 第三軍醫(yī)大學大坪醫(yī)院野戰(zhàn)外科研究所放射科;
【基金】：重慶市自然科學基金重點項目(CSTC2012jj B10028) 第三軍醫(yī)大學臨床科研基金(2009XLC29)~~
【分類號】：R739.41;R445.2
【正文快照】： 磁共振灌注成像是目前用于腦膠質瘤分級診斷評價的前沿技術之一。其中T*2加權動態(tài)磁敏感對比度(dynamic susceptibility contrast,DSC)MRI提供了顱內腫瘤的血流動力學信息,是國內臨床上研究腦膠質瘤病理分級最廣泛使用的方法,在腦膠質瘤的診斷及分級等評價方面具有重要的價值

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