多模态磁共振技术在胶质瘤复发与放射性脑损伤鉴别诊断中的应用价值

发布时间：2018-06-13 23:31

本文选题：神经胶质瘤 + 肿瘤复发　；参考：《解放军医学杂志》2015年11期

【摘要】：目的探讨联合应用弥散加权成像(DWI)、灌注加权成像(PWI)、磁共振波谱成像(MRS)等磁共振成像技术对胶质瘤复发与放射性脑损伤的鉴别诊断价值。方法回顾性分析2011年1月-2013年12月32例在北京军区总医院就诊的胶质瘤术后放疗患者的临床及影像学资料,其中胶质瘤复发15例,放射性脑损伤17例。分析32例患者的DWI、PWI、MRS等磁共振影像学资料,比较异常强化区与对侧正常区的磁共振表观扩散系数(ADC)、自动生成脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)、胆碱(Cho)/磷酸肌酸(Cr)比值及Cho/N-乙酰天门冬氨酸(NAA)比值。结果胶质瘤复发组ADC值与放射性脑损伤组比较差异无统计学意义(P0.05)。胶质瘤复发组相对脑血流量(r CBF)、相对脑血容量(r CBV)的最大值和平均值明显高于放射性脑损伤组(P0.05),相对平均通过时间(r MTT)的最大值和平均值与放射性脑损伤组比较差异无统计学意义(P0.05)。胶质瘤复发组的Cho/Cr和Cho/NAA比值均明显高于放射性脑损伤组(P0.05)。对胶质瘤复发的诊断灵敏度,单用PWI为80%,单用MRS为73.3%,PWI联合MRS为93.3%。对放射性脑损伤的诊断灵敏度,单用PWI为82.4%,单用MRS为70.6%,PWI联合MRS为88.2%。结论联合应用多模态磁共振成像技术可提高胶质瘤复发及放射性脑损伤的诊断准确性,为临床治疗提供良好的指导。
[Abstract]:Objective to investigate the value of combined use of diffusion weighted imaging (DWI), perfusion weighted imaging (PWI) and magnetic resonance spectroscopy (MRS) in the differential diagnosis of glioma recurrence and radiation brain injury. Methods the clinical and imaging data of 32 patients with glioma treated in Beijing military region General Hospital from January 2011 to December 2013 were retrospectively analyzed. 15 cases of glioma recurred and 17 cases of radiation brain injury. The magnetic resonance imaging data of 32 patients with DWI PWI Mrs were analyzed. The apparent diffusion coefficient (ADCA) of the abnormal enhancement area and the contralateral normal area were compared. The cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), choline chorion / creatine phosphate (Cr) and the ratio of ChoP / NAA were compared. Results there was no significant difference in ADC value between recurrent glioma group and radiation brain injury group (P 0.05). The maximum and average values of relative cerebral blood flow (rCBFN) and relative cerebral blood volume (rCBV) in glioma recurrence group were significantly higher than those in radiation brain injury group (P 0.05), and the mean relative mean transit time (MTT) was higher than that in radiation brain injury group. The difference was not statistically significant (P 0.05). The ratios of Cho / Cr and ChoP / NAA in glioma recurrent group were significantly higher than those in radiation brain injury group (P 0.05). In the diagnosis of glioma recurrence, the sensitivity of PWI alone was 80, that of Mrs alone was 73.3% and that of PWI combined with Mrs was 93. 3%. The diagnostic sensitivity of radiation-induced brain injury was 82.4 with PWI alone and 88.2with Mrs with 70.6PWI. Conclusion the combined use of multimodal magnetic resonance imaging can improve the diagnostic accuracy of glioma recurrence and radiation brain injury and provide good guidance for clinical treatment.
【作者单位】：北京军区总医院附属八一脑科医院神经影像科;
【分类号】：R739.41;R445.2

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