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1、DOI:10.16016/j.1000-5404.201410173DSC-MRI和DCE-MRI定量分析在脑胶质瘤分级诊断中的应用黄杰,李晓光,康厚艺,张玉龙,张伟国(400042重庆,第三军医大学大坪医院野战外科研究所放射科)[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T2*加权动态磁敏感增强灌注成像(DSC-MRI)中的参数(rCBV、rCBF)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
2、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rCBV与rCBF值与肿瘤病理分级的差异,应用Pearson相关系数分析Ktrans、Ve值及rCBV、rCBF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rCBV与rCBF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
3、于低级别胶质瘤(分别为0.157±0.177/min-1vs0.029±0.020/min-1;0.601±0.246vs0.118±0.062,P<0.01)。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rCBV及rCBF值均显著高于低级别胶质瘤(2.649±1.351vs1.480±0.391;2.427±1.248vs1.377±0.545,P<0.01)。当rCB
4、V=2.043时其诊断敏感性及特异性分别95.2%和92.9%,当rCBF=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,rCBV与rCBF值用于脑胶质瘤分级均具有较强相关性,而rCBV是敏感性及特异性最高的参数,其次是Ktrans、Ve和rCBF。[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[中图法分类号][文献标志码]ADynamiccontrastenhancedmagneticresonanceimaginganddynamicsusc
5、eptibilitycontrastmagneticresonanceimagingingradingofgliomaHuangJie,LiXiaoguang,KangHouyi,ZhangYulong,ZhangWeiguo(DepartmentofRadiology,InstituteofSurgeryResearch,DapingHospital,ThirdMilitaryMedicalUniversity,Chongqing,400042,China)[Abstract]Objective:To
6、analyzethecorrelationoftheparametersderivedfromdynamiccontrastenhancedmagneticresonanceimaging(DCE-MRI),Ktrans(volumetransferconstant)andVe(volumefractionofextravascularextracellularspace),andthosefromdynamicsusceptibilitycontrastmagneticresonanceimaging
7、(DSC-MRI),rCBV(relativecerebralbloodvolume)andrCBF(relativecerebralbloodflow)withthegradesofglioma,andcomparethevaluesoftheparametersinthegrading.Methods:Atotalof85patientswithdifferenttypesofpathologicallyconfirmedgliomas,including39withlowgradegliomas(
8、LGGs)and46withhighgradegliomas(HGGs).firstlydiagnosedinourhospitalfromSeptember2013toSeptember2014wereenrolledinthisstudy.DSCMRIand/orDCE-MRIwereperformedonthepatientsbeforesurgery,andthecorrespondingperfusionparameterswer