卒中样表现脑胶质瘤的临床影像学特点及其与预后的相关性

The correlation between the prognosis and clinical imaging characteristics of 29 cases with strokelike glioma

目的探讨卒中样表现脑胶质瘤的临床影像学特点及其与预后的相关性。方法选取2009年1月至2011年12月间收治的卒中样表现脑胶质瘤患者29例,均行动态CT检查,分析预后情况并进行相关性分析。结果脑胶质瘤CT图像主要表现为圆形、类圆形,肿瘤边界清楚。肿瘤区的脑血流量(CBF)、脑血容量(CBV)和表面通透性(PS)值明显高于健侧区,而平均通过时间(MTT)值明显低于健侧区,差异均有统计学意义(P<0.05)。所有患者随访18个月,复发率为10.3%,死亡率为13.8%。Pearson分析结果显示,脑胶质瘤复发和死亡情况与动态CT的CBF、CBV和PS值呈明显正相关(P<0.05)。多元Logistic回归分析结果显示,影响预后复发与死亡的主要因素有CBF、CBV和PS值(P<0.05)。结论卒中样表现脑胶质瘤采用动态CT检查能够有效反映其病理特征,对于预后判断有一定的参考价值,能更好地指导治疗方案的制订和提高治愈率。

Objective To investigate the correlation between the prognosis and clinical imaging characteristics of 29 cases with stroke-like glioma. Methods Selected 29 cases of stroke-like glioma from January 2009 to December 2011 admitted to the brain meurosurgery department on my hospital, all case were given the dynamic CT examination and prognosis investigation, and were given the associated data ana- lyzed. Results The glioma were mainly showed round, oval, tumor boundaries clear. The cerebral blood flow （CBF）, cerebral blood volume （CBV） and permeability surface （PS） values of the tumor area were significantly higher than the contralateral area, and mean transit time （MTY） values were significantly lower than the contralateral area that compared to the differences were statistically significant （P 〈0. 05）. All patients were followed up for 18 months, the recurrence rate was 10. 3%, the mortality rate was 13. 8%. Pearson analysis showed glioma recurrence and death were positiv related to the dynamic CT in CBF, CBV and PS values （P 〈 0. 05）. Multivariate logistic regression analysis showed that the prognosis of recurrence and mortality risk factors were included the CBF, CBV and PS values （P 〈 0. 05 ）. Conclusion Stroke- like glioma performance with dynamic CT examination can effectively reflect its pathological features, and it has certain reference value for prognosis, as to better guide the development of treatment programs and improve the cure rate.