3.0T磁共振DTI成像在脑胶质瘤分级中的临床应用评价

Clinical application and evaluation of 3.0T magnetic resonance diffusion tensor imaging in grading cerebral gliomas

目的评价MR扩散张量成像(DTI)在脑胶质瘤分级中的应用价值。方法对27例经手术病理证实的胶质瘤患者进行DTI分析,测定ADC值及FA值,感兴趣区选定在肿瘤实质区、瘤周水肿区及对侧正常脑白质三个区域,并计算肿瘤实质区、瘤周水肿区与对侧脑白质区的比值得到相对FA(r FA)值和相对ADC(r ADC)值。利用纤维束追踪技术重组肿瘤周围纤维束三维图,评价纤维束状态。结果 27例胶质瘤患者,其中低级别胶质瘤12例,高级别胶质瘤15例。r FA值在高级、低级别胶质瘤肿瘤实质区、瘤周水肿区之间差异无统计学意义(P>0.05),而r ADC值差异有统计学意义(P<0.05);纤维束的状态在高级、低级别胶质瘤之间差异亦有统计学意义。结论 DTI可清楚显示肿瘤与周围纤维束的关系,r ADC值对胶质瘤分级具有一定价值。

Objective To study the application value of magnetic resonance diffusion tensor imaging （DTI） in grading cerebral gliomas. Methods DTI analysis was performed on 27 patients of glioma confirmed by operation and pathology, and ADC value and FA value were determined. The region of interest selected were in the tumor re-gion, peritumoral edema and the contralateral cerebral white matter, and relative FA and relative ADC were calculated by the ratio of tumor region, peritumoral edema region and the contralateral cerebral white matter. Fiber beam tracking technology was used to restructure 3D graph of fiber bundle around tumor, and the state of fiber bundle was evaluated. Results In the 27 patients of glioma, there were 12 patients of low grade gliomas and 15 patients of high grade glio-mas. rFA values between high, low grade glioma tumor region, peritumoral edema region showed no significant differ-ence （P〉0.05）, while the rADC values had significant differences （P〈0.05）. The state of fiber bundles also had statisti-cally significant difference between high, low grade glioma. Conclusion DTI can clearly display the relationship be-tween tumor and surrounding fiber bundle. rADC value has a certain value in the classification of gliomas.