【摘要】：目的探討定量動(dòng)態(tài)對(duì)比增強(qiáng)磁共振成像(DCE-MRI)滲透性與T1灌注多參數(shù)聯(lián)合分析對(duì)腦膠質(zhì)瘤分級(jí)的診斷價(jià)值。方法回顧性分析經(jīng)病理證實(shí)的16例高級(jí)別腦膠質(zhì)瘤(HGG)和12例低級(jí)別腦膠質(zhì)瘤(LGG)患者的磁共振平掃和DCE-MRI資料,通過藥代動(dòng)力學(xué)模型定量計(jì)算腫瘤的滲透性參數(shù)及T1灌注模型計(jì)算灌注參數(shù),包括轉(zhuǎn)運(yùn)常數(shù)(Ktrans)、部分細(xì)胞外血管外間隙容量(ve)、血液回流常數(shù)(kep)、血漿容積(vp)和腦血流量(CBF)、腦血容量(CBV)及平均通過時(shí)間(MTT)。以t檢驗(yàn)比較HGG和LGG定量分析參數(shù)的統(tǒng)計(jì)學(xué)差異,并以受試者工作特征曲線評(píng)估滲透性參數(shù)(Ktrans值、ve值)、T1灌注參數(shù)(CBF值、CBV值)及聯(lián)合應(yīng)用灌注和滲透性參數(shù)進(jìn)行腦膠質(zhì)瘤的分級(jí)診斷的敏感性、特異性和曲線下面積。結(jié)果 HGG的Ktrans值、ve值、CBF值和CBV值分別為(0.276±0.164)/min、0.486±0.191、(1.755±1.164)ml/(g·min)和(0.204±0.101)ml/g,明顯高于LGG的(0.084±0.044)/min、0.274±0.132、(0.761±0.625)ml/(g·min)和(0.115±0.097)ml/g(t值分別為3.934、3.293、2.672和2.338,P均0.05),而HGG的kep值、vp值和MTT值分別為(1.632±1.204)/min、0.114±0.107和(0.128±0.070)min,與LGG的(1.537±1.194)/min、0.055±0.039、(0.145±0.066)min比較差異無(wú)統(tǒng)計(jì)學(xué)意義(t值分別為0.208、1.823和0.668,P均0.05)。單參數(shù)中以Ktrans值診斷腦膠質(zhì)瘤分級(jí)的曲線下面積最大,為0.919,取閾值為0.105/min時(shí),診斷高級(jí)別腦膠質(zhì)瘤的敏感性和特異性分別為87.5%和83.3%;而聯(lián)合運(yùn)用多參數(shù)分級(jí)診斷時(shí),以ve-CBF值似然比為0.631時(shí)曲線下面積最大,為0.974,敏感性和特異性分別為93.7%和100.0%。結(jié)論聯(lián)合DCE-MRI的滲透性參數(shù)與灌注參數(shù)能夠提高高級(jí)別和低級(jí)別腦膠質(zhì)瘤分級(jí)的診斷率。
[Abstract]:Objective to evaluate the diagnostic value of quantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) permeability and T 1 perfusion multiparameter analysis in glioma grading. Methods the MRI and DCE-MRI data of 16 cases of high grade glioma (HGG) and 12 cases of low grade glioma (LGG) confirmed by pathology were analyzed retrospectively. The permeability parameters of tumor were quantitatively calculated by pharmacokinetic model and perfusion parameters were calculated by T1 perfusion model, including transport constant (Ktrans), partial extracellular intervascular volume (ve), blood return constant (kep), Plasma volume (vp) and cerebral blood flow (CBF), brain blood volume (CBV) and mean transit time (MTT). T test was used to compare the statistical differences between quantitative analysis parameters of HGG and LGG, and permeability parameters (Ktrans, ve), T1 perfusion parameters (CBF) were evaluated by operating characteristic curve. CBV) and the sensitivity, specificity and area under the curve of grading of gliomas using perfusion and permeability parameters. Results the Ktrans value, ve value, CBF value and CBV value of HGG were (0.276 鹵0.164) / min,0.486 鹵0.191, (1.755 鹵1.164) ml/ (g min) and (0.204 鹵0.101) ml/g, respectively, which were significantly higher than those of LGG (0.084 鹵0.044) / min,. 0.274 鹵0.132, (0.761 鹵0.625) ml/ (g min) and (0.115 鹵0.097) ml/g (t = 3.934, 3.293, 2.672 and 2.338g, respectively), while the kep value of HGG was (0.761 鹵0.625) and (0.115 鹵0.097) ml/g, respectively. The values of vp and MTT were (1.632 鹵1.204) / min,0.114 鹵0.107 and (0.128 鹵0.070) min, and (1.537 鹵1.194) / min,0.055 鹵0.039, respectively. (0.145 鹵0.066) min had no significant difference (t = 0.208, 1.823 and 0.668, respectively). In the single parameter, the area under the curve of Ktrans was the largest (0.919). When the threshold value was 0.105/min, the sensitivity and specificity of the high-grade gliomas were 87.5% and 83.3%, respectively. The area under the curve of ve-CBF likelihood ratio of 0.631 was the largest (0.974), and the sensitivity and specificity were 93.7% and 100.0%, respectively. Conclusion the combination of permeability parameters and perfusion parameters of DCE-MRI can improve the diagnostic rate of high grade and low grade gliomas.
【作者單位】： 浙江大學(xué)湖州醫(yī)院湖州市中心醫(yī)院放射科;
【基金】：湖州市科技局計(jì)劃項(xiàng)目(2014GY22)~~
【分類號(hào)】：R445.2;R739.41

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 張薇;張龍江;黃偉;;動(dòng)態(tài)對(duì)比增強(qiáng)MRI的基本原理及其在肝臟病變的應(yīng)用[J];國(guó)際醫(yī)學(xué)放射學(xué)雜志;2014年01期

【共引文獻(xiàn)】

相關(guān)期刊論文 前2條

1 賈龍威;牛蕾;馬文帥;劉學(xué)軍;馮衛(wèi)華;隋慶蘭;;血流動(dòng)力學(xué)雙室模型Extended Tofts Linear在腦膠質(zhì)瘤DCE-MRI滲透性定量分析的復(fù)測(cè)性及有效性研究[J];磁共振成像;2015年08期

2 盧曉冬;何業(yè)銀;楊維;楊明;;原發(fā)性肝癌的MRI增強(qiáng)表現(xiàn)臨床分析[J];中外醫(yī)學(xué)研究;2015年27期

【二級(jí)參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 楊輝;于德新;馬祥興;張曉明;李傳福;;3.0T磁共振動(dòng)態(tài)增強(qiáng)掃描量化參數(shù)在肝臟占位性病變鑒別診斷中的應(yīng)用[J];山東大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2010年04期

2 Sasitorn Petcharunpaisan;Joana Ramalho;Mauricio Castillo;;Arterial spin labeling in neuroimaging[J];World Journal of Radiology;2010年10期

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 趙忠鑫;蘭凱;徐鵬;張瑜;肖家和;賀民;;徑向基神經(jīng)網(wǎng)絡(luò)在膠質(zhì)瘤分級(jí)中的應(yīng)用[J];生物醫(yī)學(xué)工程學(xué)雜志;2010年06期

2 王怡,王涌,黃詠紅,金毅,謝立乾;對(duì)術(shù)中超聲在神經(jīng)膠質(zhì)瘤分級(jí)中的診斷價(jià)值的探討[J];中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志;2004年02期

3 凌華威,丁蓓,江泓,胡錦清,董海鵬,陳克敏;多層螺旋CT灌注對(duì)腦膠質(zhì)瘤分級(jí)的初步研究[J];診斷學(xué)理論與實(shí)踐;2005年04期

4 張軍;李克;湯偉軍;顧菲菲;唐燁;;磁敏感加權(quán)成像在膠質(zhì)瘤分級(jí)中的應(yīng)用價(jià)值初探[J];中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志;2008年06期

5 廖海波;肖新蘭;;磁共振擴(kuò)散峰度成像技術(shù)原理及在膠質(zhì)瘤分級(jí)中的應(yīng)用[J];臨床放射學(xué)雜志;2013年12期

6 黃文起;;磁共振擴(kuò)散張量成像在膠質(zhì)瘤分級(jí)中的應(yīng)用[J];中國(guó)CT和MRI雜志;2012年02期

7 李軍;張雪雁;張林;郭蘭田;;氫質(zhì)子波譜分析對(duì)膠質(zhì)瘤分級(jí)及瘤周浸潤(rùn)的應(yīng)用價(jià)值[J];中外醫(yī)療;2009年36期

8 張正保;覃川;晏怡;李柏成;張彪;胡建剛;楊秀江;;血清胰島素生長(zhǎng)因子-1和膠質(zhì)纖維酸性蛋白在腦膠質(zhì)瘤分級(jí)及預(yù)后評(píng)估中的臨床價(jià)值[J];華西醫(yī)學(xué);2013年01期

9 洪建斌;許乃滔;侯志雄;;多層螺旋CT灌注成像在腦膠質(zhì)瘤分級(jí)中的價(jià)值與微血管密度的相關(guān)性研究[J];檢驗(yàn)醫(yī)學(xué)與臨床;2014年09期

10 李軍;張雪雁;姜興岳;郭蘭田;;磁共振彌散張量成像對(duì)膠質(zhì)瘤分級(jí)及瘤周浸潤(rùn)的應(yīng)用研究[J];濱州醫(yī)學(xué)院學(xué)報(bào);2009年06期

相關(guān)會(huì)議論文 前8條

1 譚海波;管一暉;張政偉;;~(11)C-Choline PET顯像在膠質(zhì)瘤分級(jí)及預(yù)后中的應(yīng)用[A];中華醫(yī)學(xué)會(huì)第九次全國(guó)核醫(yī)學(xué)學(xué)術(shù)會(huì)議論文摘要匯編[C];2011年

2 任大衛(wèi);孫瑯，

本文編號(hào)：2384701