rCBV在T2^＊-PWI鉴别脑胶质瘤复发与放射性坏死中的价值

目的：探讨rCBV在T2^＊-PWI脑胶质瘤复发与放射性坏死鉴别诊断中的应用价值。方法15例放射性坏死、9例脑胶质瘤复发患者在3.0T磁共振仪作传统平扫及增强的基础上行T2^＊-PWI，后处理在Philips EWS工作站完成。分别以病灶强化区、水肿区及正常对照区为感兴趣区，得到nrCBV值，以独立样本t检验比较脑胶质瘤复发及放射性坏死病灶的强化区、水肿区nrCBV值的差异。结果脑胶质瘤复发病灶的强化区与水肿区nrCBV值均高于放射性坏死区。脑胶质瘤复发病灶的强化区与水肿区nrCBV值分别为（3.27±2.32）和（1.17±0.56），放射性坏死病灶的强化区与水肿区nrCBV值分别为（0.97±0.57）和（0.58±0.22），强化区nrCBV值的诊断敏感性及特异性分别为88.2%和97.4%，而水肿区为92.3%和100%。结论脑胶质瘤复发病灶的强化区与水肿区nrCBV值均高于放射性坏死，利用T2^＊-灌注加权成像可以提高脑胶质瘤复发与放射性坏死的鉴别诊断正确率。

Objective To investigates the T2^＊-perfusion-weighted imaging to improve the differential diagnosis between the glioma recurrence and radiation necrosis. Materials and Methods Fifteen cases of radiation injury and 9 cases of glioma recurrence were retrospectively studied. The nrCBV values in the enhancing part,peri-local edema,and contralateral normal white matter were measured using a commercially available post-processing workstation. Results The nrCBV values in the enhancing part and peri-local edema of glioma recurrence were higher than those of radiation injury. The nrCBV values in the enhancing part of glioma recurrence and radiation injury were 3.27±2.32 and 1.17±0.56,and in the peri-local edema,they were 0.97±0.57 and 0.58±0.22,respectively. The sensitivity and specificity of nrCBV values in the enhancing part were 88.2%and 97.4%,and in the peri-local edem were 92.3%and 100%,respectively. Conclusion The nrCBV value of Glioma recurrence was higher than the radiation necrosis.The T2^＊-perfusion-weighted imaging can significantly improve the differential diagnosis between glioma recurrence and radiation necrosis.