CT灌注与MRI增强在脑膜瘤术前分型的作用

Comparison of CT Perfusion and Enhanced MRI in Preoperative Evaluation of Subtype of Meningiomas

目的比较CT灌注成像与MR I增强检查对脑膜瘤分型的价值。方法对23例经手术病理证实的脑膜瘤患者行CT血流灌注成像及MR I增强扫描,计算肿瘤实质强化区的T1强化率,CT原始图像推经灌注软件处理获得灌注参数。结果MR I增强检查纤维型、血管瘤型及上皮型脑膜瘤的T1强化程度有显著性差异。各型脑膜瘤的血容量、血流量、血管通透性间存在统计学差异。水肿程度与血管通透性的Spearman秩相关分析有显著相关性(r=0.676,P<0.01)。肿瘤实质区血容量、血流量、血管通透性与相应T1强化率比较,所得Pearson相关系数分别为0.937、0.917、0.753(P<0.05)。结论脑膜瘤MR T1强化率与CT血流灌注间具有明显的正相关,两者对脑膜瘤的术前分型均有一定诊断价值,但CT灌注能够在术前提供更详细明确的血液动力学信息。

Objective To compare the values in diagnosis of subtypes of meningioma by using multislice helical CT perfusion imaging with enhanced MR imaging. Methods Twenty-three patients with meningiomas underwent MR and muhislice CT perfusion imaging preoperatively. The signals were assessed and the T1 enhanced ratio on en- hanced MR was calculate. CT data were processed by perfusion software to obtain color perfusion maps, and perfusion parameters were calculated. Results The T1 enhanced ratios were significantly different for the meningothelial, angiomathous and fibroblastic types of meningiomas. Likewise, a significant difference in cerebral blood volume （CBV）, cerebral blood flow （CBF） , permeability surfaces （PS） was found in the three groups. Spearman correlation between PS and edema degree was （ r = 0. 676, P 〈 0.01 ）. Pearson correlations were as follows ： CBV and T1 enhanced ratio, r =0. 937,CBF and T1 enhanced ratio, r =0. 917,PS and T1 enhanced ratio（r =0. 753,P 〈0.05）. Conclusion The TI enhanced ratio and CT perfusion parameters have strong correlations, and both are useful to predict the subtypes of meningiomas. However CT perfusion imagery is a more quantitative approach to provide hemodynamic information for evaluation of subtypes of meningiomas before operation.