DSC-MRI和DCE-MRI定量分析在脑胶质瘤分级诊断中的应用

发布时间：2018-02-04 14:30

  本文关键词： 胶质瘤 动态对比增强灌注成像 动态磁敏感增强灌注成像　出处：《第三军医大学学报》2015年07期 　论文类型：期刊论文

【摘要】：目的定量分析T1加权动态对比增强成像(DCE-MRI)中的参数(Ktrans、Ve)和T*2加权动态磁敏感增强灌注成像(DSC-MRI)中的参数(r CBV、r CBF)与肿瘤病理分级的相关性,比较DCE-MRI及DSC-MRI参数在脑胶质瘤分级诊断中的价值。方法病理证实的85例脑胶质瘤患者,低级别胶质瘤36例,高级别胶质瘤49例。患者在术前行DCE-MRI成像或/和DSC-MRI成像,以相应后处理软件获得灌注参数值。采用单因素方差分析比较不同级别胶质瘤Ktrans与Ve值及r CBV与r CBF值与肿瘤病理分级的差异,应用Pearson相关系数分析Ktrans、Ve值及r CBV、r CBF值与胶质瘤级别之间的相关性。应用ROC曲线分析获得Ktrans、Ve值及r CBV与r CBF值鉴别不同级别胶质瘤的最佳阈值及其敏感性和特异性。结果高级别胶质瘤的平均Ktrans及Ve值均显著高于低级别胶质瘤[分别为(0.157±0.177)/min-1vs(0.029±0.020)/min-1;(0.601±0.246)vs(0.118±0.062),P0.01]。当Ktrans=0.055/min-1时其诊断敏感性及特异性分别为89.7%和90.5%,当Ve=0.343时其诊断敏感性及特异性分别为86.2%和85.7%。高级别胶质瘤的平均r CBV及r CBF值均显著高于低级别胶质瘤[(2.649±1.351)vs(1.480±0.391);(2.427±1.248)vs(1.377±0.545),P0.01]。当r CBV=2.043时其诊断敏感性及特异性分别95.2%和92.9%,当r CBF=1.886时其诊断敏感性及特异性分别为85.7%和85.7%。结论 Ktrans与Ve值,r CBV与r CBF值用于脑胶质瘤分级均具有较强相关性,而r CBV是敏感性及特异性最高的参数,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 卤0.177% 路min -1 vs 0.029 卤0.020% 路min -1; 0. 601 卤0. 246VSD 0.118 卤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 卤1.351 卤1.480 卤0.391m; 2.427 卤1.248 VSD 1.377 卤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.
【作者单位】： 第三军医大学大坪医院野战外科研究所放射科;
【基金】：重庆市自然科学基金重点项目(CSTC2012jj B10028) 第三军医大学临床科研基金(2009XLC29)~~
【分类号】：R739.41;R445.2
【正文快照】： 磁共振灌注成像是目前用于脑胶质瘤分级诊断评价的前沿技术之一。其中T*2加权动态磁敏感对比度(dynamic susceptibility contrast,DSC)MRI提供了颅内肿瘤的血流动力学信息,是国内临床上研究脑胶质瘤病理分级最广泛使用的方法,在脑胶质瘤的诊断及分级等评价方面具有重要的价值

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