MR-PWI联合SWI在脑胶质瘤级别评价中的应用

Application of MR-PWI Combined with SWI in the Evaluation of Brain Gliomas

目的:探究MR-PWI联合SWI在脑胶质瘤级别评价中的应用。方法:选取本院2015年6月-2016年2月经手术及组织病理学证实为脑胶质瘤的患者50例,按照世界卫生组织(WHO)2007标准,将病例分为低级别(1、2级)脑胶质瘤组21例,高级别(3、4级)脑胶质瘤组29例,所有患者术前均行MR-PWI联合SWI检查。通过药代动力学模型计算两组患者检查结果中肿瘤的定量分析容积转运参数(Ktrans)、血管外细胞外容积分数(Ve)、速率常数(Kep)等参数,测量两组脑胶质瘤肿瘤区的1H-MRS代谢物rCho、rCr及rNAA值,两组患者肿瘤实质及肿瘤边际的ADC值。结果:高级别脑胶质瘤组中Ktrans、Ve、Kep值均高于低级别脑胶质瘤组,差异均有统计学意义(P<0.05);高级别脑胶质瘤组rCho、rCr及rNAA值均较低级别脑胶质瘤组有不同程度增加,差异均有统计学意义(P<0.05);低级别脑胶质瘤组实质及肿瘤边际ADC值均高于高级别脑胶质瘤组,差异均有统计学意义(P<0.05)。结论:MRPWI联合SWI检查有利于脑胶质瘤分级的诊断。

Objective： To explore the application of MR-PWI combined with SWI in the grade evaluation of brain glioma.Method： From June 2015 to February 2016, 50 patients with glioma confirmed by surgery and histopathology in our hospital were divided into low grade brain glioma group and high grade brain glioma group according to WHO standard of 2007.Among which 21 patients with low grade （ grade 1-2 ） brain glioma and 29 patients with high grade （ grade 3-4 ）brain glioma, all patients were adopted preoperative MR-PWI combined with SWI.The examination results included tumor Volume transport parameters （ Ktrans ）, extravascular extracellular volume fraction （ Ve ）, the rate constant （ Kep ） of two groups were analysed by pharmacokinetic model, and other parameters include glioma tumor 1H,MRS metabolites rCho, rCr value and rNAA value, ADC of tumor essence, tumor marginal of two groups were measured.Result： Ktrans, Ve and Kep of high grade brain glioma group were higher than those of low grade brain glioma group, the differences were statistically significant （ P〈O.05 ） .The values of rCho, rCr and rNAA of high grade brain glioma group were increased than those of low grade brain glioma group, the differences were statistically significant （ P〈O.05 ） .ADC values of tumor parenchymal and marginal of low grade brain glioma group were higher than those of high grade brain glioma group, the differences were statistically significant （ P〈0.05 ） .Conclusion： MR-PWI combined with SWI are helpful for the grading diagnosis of brain glioma.