MR灌注加权成像对脑胶质瘤病理分级的临床研究

目的 探讨磁共振(MR)灌注加权图像对脑胶质瘤病理分级的临床应用价值.方法 选择经病理证实的30例胶质瘤患者入组研究.分为高级和低级两组,其中低级胶质瘤14例(Ⅰ级1例,毛细胞型星形细胞瘤;Ⅱ级13例,星形细胞瘤11例包括1例术后复发,室管膜瘤1例,少突胶质细胞瘤1例);高级胶质瘤16例(Ⅲ级11例,均为间变性星形细胞瘤,包括1例为术后复发;Ⅳ级5例,胶质母细胞瘤4例,室管膜瘤1例).行MR灌注加权成像,测量肿瘤实质的局部相对脑血容量(rCBV)、相对平均通过时间(rMTT)、相对最大下降斜率(rMSD)值,进行统计学分析.结果 低级胶质瘤的rCBV、rMSD、rMTT值分别为1.99±1.00,1.83±0.78,1.10±0.08,高级胶质瘤的rCBV、rMSD、rMTT值分别为4.95±2.04.3.59±1.13.1.03±0.61.高级与低级胶质瘤的rCBV、rMSD值比较,差异均有统计学意义(P<0.05).以低级胶质瘤实质rCBV、rMSD值的上限2.99、2.61作为判断阈值,诊断正确率分别为83.3%、80%.结论 rCBV、rMSD值对脑胶质瘤分级的诊断有较高的准确性.

Clinical value of perfusion-weighted magnetic resonance imaging in the wading of gliomas

Objective To investigate the value of perfusion-weighted magnetic resonanceimaging (MRI) in the grading ofgliomas. Methods Thirty patients with pathologically confirmedglioma underwent perfusion-weighted MRI. Of the 30 glioma patients, 14 patients had low-grade and 16had high-grade gliomas. The low-grade glioma patients included 1 with WHO grade Ⅰ glioma (pilocyticastroeytoma) and 13 with WHO grade Ⅱ gliomas; in the WHO grade Ⅱ patients, 11 had astrocytomaincluding I with postoperative recurrence, 1 with epeudymoma, and 1 with oligodendroglioma. Of the 16patients with high-grade gliomas, 11 had WHO grade Ⅲ gliomas identified as anaplastic astrocytoma(including 1 with postoperative recurrence) and 5 had WHO Ⅳ gliomas (including 4 with glioblastomamultiforme and 1 with ependymoma). The relative cerebral blood volume (rCBV), rMSD and relativemean transit time (rMTT) were measured and statistically analyzed in these patients. Results TherCBV, rMSD and rMTT were 1.99±1.0, 1.83±0.78, and 1.10±0.08 in the patients with low-grade gliomas,as compared to those in the high-grade giioma patients of 4.95±2.04, 3.59±1.13, and 1.03±0.61,respectively, showing significant differences in the rCBV and rMSD between the two groups (P<0.05).The diagnostic accuracy of rCBV and rMSD was 83.3% and 80% for the gliomas using their upper limits(2.99 and 2.61, respectively) as the diagnostic thresholds. Conclusion The values ofrCBV and rMSDhave high accuracy in the grading of brain gliomas.