高b值扩散加权成像对脑胶质瘤边缘带的分析初探

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1、新疆医科大学硕士学位论文高b值扩散加权成像对脑胶质瘤边缘带的研究初探研究生：姜春晖导师：王俭副教授摘要目的：应用高b值的扩散加权成像（DWI）探讨脑胶质瘤边缘带的ADC值变化特点，评价上述方法对不同级别脑胶质瘤边缘带的应用价值。材料与方法：收集经手术病理确诊或临床随诊1年以上并综合影像学检查确诊的脑胶质瘤16例，其中高级别（WHOⅢ-Ⅳ级）胶质瘤11例，低级别胶质瘤（WHOⅠ-Ⅱ级）5例；分别进行常规T1WI、T2WI、FLAIR平扫序列检查，而后行DWI检查、最后注射钆对比剂行MR增强扫描。DWI分

2、两次扫描，梯度敏感因子b值分别取0s/mm2、1000s/mm2、3000s/mm2两组，测量肿瘤实质、瘤周水肿区及水肿区周围正常脑白质区的ADC值及对侧镜像正常脑白质的ADC值，并进行统计学分析。结果：b值为1000s/mm2及3000s/mm2时，高级别胶质瘤实质区、瘤周水肿区及水肿周围正常脑白质区ADC值间差异无统计学意义；低级别胶质瘤肿瘤实质及水肿区ADC值在b值为1000s/mm2时差异有统计学意义（P＜0.05），肿瘤实质明显高于瘤周水肿区，b值为3000s/mm2时差异无统计学意义；高级

3、别胶质瘤水肿周围正常脑白质区的ADC值在b值为1000s/mm2及3000s/mm2时，均明显高于对侧镜像正常脑白质区，差异有统计学意义（P＜0.05）；低级别胶质瘤水肿周围正常脑白质区的ADC值在b值为1000s/mm2差异无统计学意义，而b值为3000s/mm2时则明显高于对侧镜像正常脑白质区，差异有统计学意义（P＜0.05）；结论：MR扩散加权成像技术有助于推测胶质瘤肿瘤细胞的浸润范围，制定最佳手术治疗方案。b=3000s/mm2的扩散加权成像对低级别胶质瘤肿瘤细胞浸润范围的推测较b=1000s

4、/mm2更为敏感。关键词：脑胶质瘤；磁共振成像；磁共振扩散加权成像；高b值1新疆医科大学硕士学位论文OnHighbValueDWItoBrainGliomaMarginalZonePostgranduate:JiangChunhuiSupervisor:Viceprof.WangJianAbstractObjective:ToresearchthefeaturesofADCvaluechangeofbraingliomamarginalzonebyhighbvaluediffusion-weighte

5、dimaging(DWI),andevaluatetheapplicationvalueofthismethodtodifferentlevelsofbraingliomamarginalzone.MaterialsandMethods:Collects15casesofbraingliomaexaminedforover6monthsthroughclinicalpathologicaldiagnosisorfollow-up,inwhich11casesofhigh-grade(WHOIII-IV

6、grade)glioma,5casesoflow-grade(WHOI-IIgrade).BothwerecarriedconventionalT1WI,T2WIandFLAIRplainscansequencechecking;thenDWIchecking;finally,injectedwithGD-DTPAforMRenhancementscanning.TheDWIcheckingweretakentwice,withgradient-sensitivefactorbvalueat0s/mm

7、2,1000s/mm2，3000s/mm2respectively,tomeasuretheADCvalueofnormalbraintissuesurroundtumorparenchymaorsteroidarea,andADCvalueofsidemirrornormalbraintissue,forstatisticallyanalyzingbetweenthetwogroups.Results:Whenbvalueis1000s/mm2and3000s/mm2,theADCvalueofno

8、rmalbraintissuesurroundhigh-gradeandlow-gradetumorparenchymaorsteroidareaislowerthansidemirrornormalbraintissue,withstatisticallysignificantdifference(P<0.05);whilecomparingtheADCvalueofnormalbraintissuesurroundtwodifferentb-valu