MR灌注加权成像鉴别诊断单发脑转移瘤与高级别胶质瘤

MR perfusion-weighted imaging in differential diagnosis between solitary cerebral metastatic tumors and high-grade gliomas

目的探讨MR PWI鉴别诊断单发脑转移瘤和高级别胶质瘤的价值。方法回顾性分析脑内单发转移瘤患者18例和高级别胶质瘤患者25例的MR PWI特征。所有患者均接受常规MR平扫、PWI及增强检查。分别测量瘤体、瘤周水肿区(瘤周区)及对侧正常白质区的脑血容量(CBV)值,得出瘤体、瘤周水肿区相对脑血容量(rCBV)值,同时测得时间-信号强度曲线图肿瘤瘤体及瘤周水肿区的相对峰值(rPH)、瘤体的信号强度恢复百分比(PSR),并进行统计学分析。结果高级别胶质瘤和单发脑转移瘤瘤体区的rCBV差异无统计学意义(P>0.05);高级别胶质瘤瘤周区rCBV大于单发脑转移瘤(P<0.05)。高级别胶质瘤瘤体及瘤周区rPH均高于转移瘤组(P均<0.05);高级别胶质瘤瘤体区PSR大于转移瘤(P<0.05)。结论 MR PWI可提供瘤体、瘤周区的血流灌注特征以及瘤体血脑屏障破坏情况,有助于鉴别单发脑转移瘤和高级别胶质瘤。

Objective To investigate the differential diagnosis value of MR PWI between solitary cerebral metastatic tumors and high-grade gliomas.Methods Forty-three patients,including 18 patients with solitary cerebral metastatic tumors and 25 patients with high-grade gliomas,were analyzed retrospectively.All patients underwent conventional MR imaging,contrast-enhancement and PWI.The relative cerebral blood volume（rCBV）were obtained from regions of enhanced tumoral bodies,peritumoral regions and contralateral normal white matter regions respectively.At the same time,the relative peak height（rPH）of enhanced tumoral bodies and peritumoral regions and the percentage of signal intensity recovery（PSR）of enhanced tumoral bodies were measured.The statistical analysis were performed.Results The rCBV had no statistical difference between two kinds of tumors（P〈0.05）.The rCBV of peritumoral regions in high-grade gliomas was statistically higher than that of solitary cerebral metastatic tumors（P〉0.05）.The rPH of tumoral bodies and peritumoral regions in high-grade gliomas were all statistically higher than those of solitary cerebral metastatic tumors（P〈0.05）,the PSR of tumoral bodies were also higher than that of solitary cerebral metastatic tumors（P〈0.05）.Conclusion MR PWI is helpful to differentiate solitary cerebral metastatic tumors from high-grade gliomas by offering the information of the hemodynamic features in tumors body and peritumoral areas and the damage of blood brain barrier in tumors body.