联合应用DWI及PWI对脑内肿瘤及瘤周水肿的比较研究

To Analyze Brain Tumors and Peritumoral Brain Edema using MR Perfusion Weighted Imaging Combined with MR Diffusion Weighted Imaging

目的应用DWI及PWI的各项相关参数对低级别胶质瘤、高级别胶质瘤、淋巴瘤及转移瘤的生长趋势,血管生成及瘤周侵犯的情况进行评价。方法应用DWI及PWI检查脑内占位病例54例。分别以肿瘤瘤体实质、肿瘤外水肿内1 cm、肿瘤外水肿内2 cm、水肿外1 cm、水肿区域以外1 cm的白质区域为感兴趣区,以正常脑白质为对照感兴趣区,分别测量各个感兴趣区的ADC、rCBV、rCBF值。将感兴趣区与对照感兴趣区的量化指标进行比值计算,得到相对ADC、相对r CBV、相对rCBF值。并对各项参数进行统计分析。结果不同肿瘤实质ADC值之间(P=0.003)以及瘤周水肿内2 cm处ADC值之间差异具有统计学意义(P=0.012)。HGG瘤体、水肿内1 cm处、水肿内2 cm处的rCBV、rrCBV、rCBF及rrCBF值均高于其他类型肿瘤,差异均存在统计学意义(P<0.05)。结论通过DWI及PWI对低级别胶质瘤、高级别胶质瘤、淋巴瘤及转移瘤这四种类型的瘤体、瘤周水肿区、水肿外区域的ADC、rCBV、rCBF值及其相对值的分析,能提高肿瘤的诊断准确率并指导临床手术切除范围。

Objective To evaluate the tumors growing tendence、angiogenesis and invasion,using DWI and PWI relative parameters of different kinds of tumors in brain（ low-grade glioma,LGG; high-grade glioma,HGG; primary central nervous system lymphoma,PCNSL; metastasis）. Methods 54 cases of tumors in brain were performed with DWI and PWI. In the research,We selected tumor＇s solid part,the area of 1cm beside tumor within edema,the area of 2cm beside tumor within edema,the area of 1cm beside edema as region of interest（ ROI） respectively,then selected normal whiter mater as contrast region. Every ROI ＇s values of apparent diffusion coefficient（ ADC）,the regional cerebral blood flow（ r CBF）,regional cerebral blood volume（ r CBV） were measured. Then the ratio of ADC、rCBV and rCBF chould be calculated. All of the relative parameters were analyzed by SPSS. Results There were significant differences among the different tumors＇ solid part（ P = 0. 012） and the area of 2cm beside tumor within edema（ P = 0. 012）. The value ＇s of rCBV,rrCBV,rCBF and rrCBF had significant differences among the different tumors at the tumor＇s solid part,the area of 1cm beside tumor within edema,the area of 2cm beside tumor within edema. Conclusion The four kinds of tumors＇ different region＇s relative parameters could improve the accuracy of clinical diagnosis,and offer the guidance to surgery.