摘要
目的 探讨动态增强T2 WMR灌注成像在脑胶质瘤术前分级预测及鉴别诊断中的价值。资料与方法 有病理或追踪结果的 4 8例脑病变患者 ,其中胶质瘤 2 5例 (高、低级别胶质瘤分别为 16例和 9例 ) ,非胶质瘤病变 2 3例。全部病例均行常规T1WI、T2 WI和EPI SE序列动态增强MR灌注成像。计算每个病灶的最大相对脑血容量 (rCBV)比值 (病灶最大rCBV/对侧正常脑白质rCBV)。分析胶质瘤的最大rCBV比值与其组织学级别的关系 ,并比较胶质瘤与非胶质瘤的灌注异常及常规MRI强化表现。结果 高级别胶质瘤 ( 16例 )的最大rCBV比值为4 .6 0± 1.98( 2 .5 5~ 9.2 2 ) ,低级别胶质瘤 ( 9例 )的最大rCBV比值为 1.86± 1.5 2 ( 0 .85~ 5 .72 ) ,经t检验 ,两组之间有显著统计学差异 (P <0 .0 1)。脑膜瘤、转移瘤、血管母细胞瘤、淋巴瘤均显示有局部高灌注 ,最大rCBV比值为5 .35± 2 .39( 3.15~ 12 .39) ,而有强化表现的脑梗死、脑炎性灶及放射性脑损伤表现为低、等灌注 ,最大rCBV比值为1.2 7± 0 .36 ( 0 .85~ 1.72 )。结论 MR灌注成像在胶质瘤的术前影像学分级预测上有重要价值 。
Objective To evaluate dynamic contrast enhanced perfusion weighted MR imaging in preoperative grading and differentiation of gliomas. Materials and Methods Forty eight patients with cerebral lesions were enrolled in this study. The diagnoses were confirmed with pathology or follow up observation. The lesions included glioma (n=25, 16 high grade and 9 low grade), meningioma (n=5), metastasis (n=5), angioreticuloma (n=3), lymphadenoma (n=1), cerebral infarction (n=5), cerebral inflammation (n=3) and radiation necrosis (n=1). Dynamic contrast enhanced EPI SE perfusion sequence and subsequent conventional T 2WI and T 1WI were performed in all patients. Using normal white matter in the contralateral hemisphere as a reference, the maximum relative cerebral blood value (rCBV) ratio was calculated for each lesion. The maximum rCBV ratio of each glioma was compared with its histological grade, and the findings of rCBV map and the enhancement pattern on conventional MRI were compared between gliomas and other brain lesions.Results The maximum rCBV ratio in high grade glioma (n=16) and low grade glioma (n=9) was 4.60±1.98 and 1.86±1.52, respectively, with P<0.01. Focal high perfusion areas were found in meningiomas, metastases, angioreticulomas and lymphadenomas, in which the maximum rCBV ratio was 5.35± 2.39. Low and iso perfusion was seen in the lesions of enhanced infarction, inflammations and radiation injuries, with a maximum rCBV ratio of 1.27±0.36.Conclusion Dynamic contrast enhanced perfusion weighted MR imaging is of great value in preoperatively predicting the pathologic grade of the gliomas and it is also helpful in the differentiation of gliomas with other cerebral lesions.
出处
《临床放射学杂志》
CSCD
北大核心
2004年第1期12-16,共5页
Journal of Clinical Radiology