磁共振灌注成像对脑内环形强化病变的鉴别诊断价值

THE VALUE OF MR PERFUSION IMAGING IN DIFFERENTIAL DIAGNOSIS OF INTRACRANIAL RING-ENHANCEMENT LESIONS

目的探讨磁共振灌注成像(PWI)在脑内环形强化病变鉴别诊断中的价值。方法收集脑内环形强化病变病人25例,包括高级别胶质瘤8例,脑转移瘤10例,脑脓肿7例。均分别进行MRI平扫、MRI增强和PWI检查。在MR后处理工作站上获得PWI伪彩图,测量病变区、周围水肿区及其对侧对应正常脑白质区相对脑血容量(rCBV),计算rCBV的比值(rrCBV)。结果高级别胶质瘤及脑转移瘤病变区的rrCBV与脑脓肿比较,差异均有统计学意义(F=96.91,t=11.23、23.70,P<0.001);高级别胶质瘤、脑转移瘤及脑脓肿周围水肿区rrCBV比较,差异均有统计学意义(F=41.57,t=2.93～8.45,P<0.05)。结论 PWI对于脑内环形强化病变的鉴别有一定的价值。

Objective To assess the value of MR perfusion imaging （MRPI） in differential diagnosis of intracranial ring- enhancement lesions （ICRELs）. Methods Twenty-five patients with ICRELs--including high-grade glioma （n=8）, metastasis tumor （n = 10） and abscess （n = 7）--were enrolled. Plan MRI, enhanced MRI and MRPI were performed. Pseudo color figures of MRPI were obtained from MR postprocessing workstation. The diseased region, its peripheral edema, and relative rCBV of the normal white matter on corresponding region of the contralateral hemisphere were measured, and rCBV ratio calculated. Results T he differences of rrCBV ratio between high-grade gliomas and parenchyma in metastases tumor and abscess were significant （F = 96.91 ; t = 11.23,23.70 ; P 〈0.001 ） ; the differences of rrCBV ratio in edema region among high-grade glioma, metastasis tumor, and abscess were significant （F=41.57,t=2.93--8.45,P〈0.001）. Conclusion MRPI has a certain value in differential diagno- sis of ICRELs.