磁共振灌注加权成像和扩散张量成像对脑胶质瘤患者的分级诊断效果

Effect of the grading diagnosis of magnetic resonance perfusion weighted imaging and diffusion tensor imaging of the patients with cerebral glioma

目的探讨磁共振灌注加权成像(PWI)和扩散张量成像(DTI)对脑胶质瘤患者的分级诊断效果。方法回顾性分析2010年1月至2014年6月间接受治疗的80例脑胶质瘤患者,经手术与病理学证实的高级别与低级别患者各40例,对比分析高低级别患者术前磁共振PWI和DTI的检查指标,根据受试者工作特征(ROC)曲线确定诊断阀值、计算敏感度和特异度。结果脑胶质瘤瘤体、瘤周及正常区间的表观扩散系数(ADC)、各向异性分数(FA)、局部脑血流量(r CBF)、局部脑血容量(r CBV)量化值的差异均有统计学意义(P<0.05);高、低级别脑胶质瘤瘤体的相对ADC(r ADC)、相对r CBF(rr CBF)、相对r CBV(rr CBV)量化值差异有统计学意义(P<0.05);脑胶质瘤瘤体ADC、rr CBF、rr CBV的AUC值均>0.9,且敏感度与特异度都很高。结论脑胶质瘤瘤体的ADC、rr CBF及rr CBV的诊断敏感度和特异度都很高;在脑胶质瘤分级诊断的过程中,脑胶质瘤瘤体的ADC、r CBF及r CBV可以作为理想的量化指标。

Objective To explore the effect of grading diagnosis of magnetic resonance perfusion weighted imaging （PWI） and diffusion tensor imaging （DTI） of the patients with cerebral glioma. Methods A retrospective analysis of 80 patients with cerebral glioma treated from January 2010 to June 2014, both of the high level and low level of the patients by the operation and pathology were 40 cases, compared analy- sis of the check indexes of preoperative magnetic resonance PWI and DTI between the high and low level pa- tients, according to the receiver operating characteristic （ROC） curve to determine the diagnostic threshold, calculate sensitivity and specificity. Results The apparent diffusion coefficient （ADC）, fractional anisot- ropy （FA）, regional cerebral blood flow （rCBF） and regional cerebral blood volume （rCBV） quantization were significant differences in the cerebral glioma tumor, peritumoral and normal interval, the difference was statistically significant （P 〈 0. 05 ）; the relative ADC （rADC）, relative rCBF （rrCBF） and relative rCBV （rrCBV） quantization between the high and low level cerebral glioma tumor was significantly different, the differ- ence was statistically significant （P 〈 0. 05） ; the AUC of the ADC, rrCBF, rrCBV of cerebral glioma tumor were more than 0. 9, and the sensitivity and specificity were high. Conclusions The diagnostic sensitivity and speci- ficity of ADC, rrCBF and rrCBV of cerebral glioma tumor are high; in the grading diagnosis of cerebral glioma, the ADC, rCBF and rCBV of cerebral glioma tumor can be used as the quantitative index of ideal.