术中超声造影定量分析在脑胶质瘤分级诊断中的应用价值

Value of blood perfusion quantitatively in grading cerebral gliomas during operation by contrast-enhanced ultrasonography

目的 探讨术中超声造影及定量分析在脑胶质瘤分级诊断中的应用价值.方法 对31例脑胶质瘤患者术中进行灰阶超声造影及Sonoliver软件定量分析.分别获取正常脑组织和肿瘤内部感兴趣区的峰值强度、达峰时间、上升时间及平均渡越时间,并对高、低级别胶质瘤和正常脑组织的造影参数进行比较分析.结果 术后病理证实15例为高级别胶质瘤,16例为低级别胶质瘤,超声造影显示峰值强度高于周围正常脑组织,达峰时间较周围正常脑组织短（P＜0.05）,平均渡越时间较周围正常脑组织长（P＜0.05）.高、低级别胶质瘤之间比较,峰值强度和达峰时间差异有统计学意义（P＜0.05）,而上升时间和平均渡越时间差异无统计学意义（P＞0.05）.结论 超声造影定量分析获得的造影参数可为脑胶质瘤的分级诊断提供有价值的信息.

Objective To explore the clinical application of blood perfusion quantitatively by contrastenhanced ultrasonography（CEUS） to grade cerebral gliomas during operation. Methods Thirty-one patients with cerebral gliomas were examined by CEUS with Sonoliver software during operation. Maximum intensity （IMAX）, time to peak （TTP）, rising time （RT） and mean transit time（mTT） of the regions of interest （ROIs） of normal brain tissue and high- and low-grade gliomas were respectively determined and comparatively analyzed. Results Fifteen high-grade gliomas and sixteen low-grade gliomas were postoperatively confirmed by pathologic results. The administration of contrast agent led to higher echo enhancement in cerebral gliomas than normal brain tissues in all cases. The TTP of high- and low-grade gliomas were significantly shorter than that of normal cerebral tissues （ P 〈0.05） ,and the mTT was longer than that of normal brain tissue（ P 〈0. 05）. There was significant differences of IMAX and TTP between high- and low-grade gliomas（P 〈0.05）, but there was no significant difference of RT and mTT between the two groups （ P 〉0.05）. Conclusions CEUS with quantitative analysis software on blood perfusion of the tumors can provide valuable information to grade cerebral gliomas.