3.0T MRI弥散张量成像对脑胶质瘤分级的诊断价值

The diagnostic value of diffusion tensor imaging for gliomas grading at 3.0T MRI

目的比较脑低、高级别胶质瘤轴位的弥散张量成像(DTI)图像,分析不同级别胶质瘤DTI特点,以提高诊断准确性。方法回顾性分析泸州医学院附属医院经手术病理证实的26例低级别胶质瘤、37例高级别脑胶质瘤的轴位T1W/DTI图像,将瘤周神经元纤维走行分为推移、中断、神经元纤维缠结(NFT)3种类型。结果 26例低级别胶质瘤中,18例肿瘤瘤周神经元纤维出现推移,8例出现中断,无1例出现NFT;37例高级别脑胶质瘤中9例肿瘤瘤周神经元纤维出现推移,21例出现中断,7例出现NFT;脑低、高级别胶质瘤组间有序变量的两独立样本比较的秩和检验显示差异有统计学意义(Z=-3.756,P<0.05);高级别胶质瘤出现NFT部位的χ2检验显示差异无统计学意义(P>0.05),其中,额叶出现1例NFT,占2.7%(1/37),颞叶出现6例NFT,占16.2%(6/37)。结论脑低级别胶质瘤瘤周神经元纤维走行在3.0T MRI/DTI图像上多表现为推移,高级别胶质瘤多表现为中断和NFT,高级别胶质瘤NFT多出现在颞叶、额叶。

Objective To explore the diagnostic value of axial diffusion tensor imaging（DTI） for gliomas grading at 3 .0T MRI , analyze the characteristics of different grades gliomas of axial DTI in order to improve diagnostic accuracy .Methods A retrospec‐tive analysis was performed involving a group of 37 cases of high grade glioma and 26 cases of low grade glioma confirmed by the pathological results in affiliated hospital of Luzhou medical college ,observation analysis was obtained in axial DTI ,peritumoral neu‐rofibrillary was divided into three types ：displacement ,interruption and neurofibrillary tangles（NFT） .Results among the 26 cases of low grade glioma ,there were 18 cases of displacement ;8 cases of interruption ,no NFT ;among the 37 cases of high grade glio‐mas ,there were 9 cases of displacement ,21 cases of interruption ,and 7 cases of NFT （1 case of frontal lobe ,6 cases of temporal lobe）;ordinal variables rank sum test in two independent samples between high grade glioma group and low grade glioma showed significant differences（Z= -3 .756 ,P〈0 .05）;χ2 test showed no significant difference（P〉0 .05） ,frontal lobe appeared NFT in 1 case ,accounting for 2 .7% （1/37） ,temporal lobe appeared NFT in 6 cases ,accounting for 16 .2% （6/37） .Conclusion Peritumoral neurofibrillary of the low grade gliomas more performed displacement ,the high grade gliomas show more interrupts and NFT at 3 .0T MRI ,NFT in high grade gliomas is often seen in the temporal and frontal lobe .