CT灌注成像技术在脑胶质瘤术前分级诊断中的价值分析

Analysis of value by CT perfusion imaging technique in preoperative grading diagnosis of brain glioma

目的分析CT灌注成像用于脑胶质瘤术前的分级效果。方法 83例经病理学确诊的脑胶质瘤患者,对患侧和健侧脑血流参数进行比较,按照病情状况分为低级组(Ⅰ~Ⅱ级)40例,高级组(Ⅲ~Ⅳ级)43例,通过分析患者入院时检测的CT灌注成像脑肿瘤实质区和正常脑组织区参数结果 ,统计各组两侧表面渗透性(PS)、脑血容量(CBV)、脑血流量(CBF)、相对脑血流量(r CBF)、相对脑血容量(r CBV)方面的参数。结果脑肿瘤实质区CBV为(11.64±3.14)ml/(100 ml·min)、PS为(13.21±4.45)ml/(100 ml·min)、CBF为(135.78±37.69)ml/1000 ml,正常脑组织区CBV(2.10±0.95)ml/(100 ml·min)、PS(0.73±0.31)ml/(100 ml·min)、CBF(26.45±6.62)ml/1000 ml,两侧r CBV为(5.54±2.81),r CBF为(5.13±3.07)。脑肿瘤实质区CBV、PS和CBF显著高于正常脑组织区,差异具有统计学意义(P<0.05);两侧r CBV、r CBF均>3。低级组脑肿瘤实质区CBV(3.76±1.56)ml/(100 ml·min)、PS(4.48±2.16)ml/(100 ml·min)、CBF(53.71±13.82)ml/1000 ml,正常脑组织区CBV(2.08±0.74)ml/(100 ml·min)、PS(0.69±0.16)ml/(100 ml·min)、CBF(25.82±5.42)ml/1000 ml;高级组CBV(17.82±4.83)ml/(100 ml·min)、PS(16.59±5.17)ml/(100 ml·min)、CBF(144.58±27.45)ml/1000 ml,正常脑组织区CBV(3.13±0.84)ml/(100 ml·min)、PS(0.76±0.28)ml/(100 ml·min)、CBF(27.15±6.93)ml/1000 ml;低级组CBV、PS与CBF显著低于高级组,差异具有统计学意义(P<0.05);低级组r CBV(1.81±0.43)、r CBF(2.08±0.75)均<3,高级组r CBV(5.69±1.79)、r CBF(5.33±1.28)均>3。结论 CT灌注成像术应用在脑胶质瘤术前的诊断中具有良好的鉴定疾病和确定分级的效果,是一种价格相对低廉,诊断效果较为理想的影像学诊断方式。

Objective To analyze effect by CT perfusion imaging in preoperative grading diagnosisof brain glioma.Methods A total of83patients with pathologically diagnosed brain glioma were taken intocomparison of cerebral blood flow indexes between affected side and unaffected side,and they were divided bydisease condition into low-grade group(gradeⅠ~Ⅱ)with40cases and high-grade group(gradeⅢ~Ⅳ)with43cases.Summarization was made on parameters of bilateral permeability surface(PS),cerebral blood volume(CBV),cerebral blood flow(CBF),relative cerebral blood flow(rCBF),and relative cerebral blood volume(rCBV)in the twogroups through comparing their parameters between brain glioma solid area and normal brain tissue area detected byCT perfusion imaging at admission.Results Brain glioma solid area showed CBV as(11.64±3.14)ml/(100ml·min),PS as(13.21±4.45)ml/(100ml·min),and CBF as(135.78±37.69)ml/1000ml,and normal brain tissue areashowed CBV as(2.10±0.95)ml/(100ml·min),PS as(0.73±0.31)ml/(100ml·min),and CBF as(26.45±6.62)ml/1000ml.The bilateral rCBV was(5.54±2.81)and rCBF was(5.13±3.07).Brain glioma solid area hadobviously higher CBV,PS and CBF than normal brain tissue area,and their difference had statistical significance(P<0.05).The bilateral rCBV and rCBF were all>3.Brain glioma solid area in the low-grade group had CBV as(3.76±1.56)ml/(100ml·min),PS as(4.48±2.16)ml/(100ml·min),and CBF as(53.71±13.82)ml/1000ml,and its normal brain tissue area had CBV as(2.08±0.74)ml/(100ml·min),PS as(0.69±0.16)ml/(100ml·min),and CBF as(25.82±5.42)ml/1000ml.Brain glioma solid area in the high-grade group had CBV as(17.82±4.83)ml/(100ml·min),PS as(16.59±5.17)ml/(100ml·min),and CBF as(144.58±27.45)ml/1000ml,andits normal brain tissue area had CBV as(3.13±0.84)ml/(100ml·min),PS as(0.76±0.28)ml/(100ml·min),and CBF as(27.15±6.93)ml/1000ml.The low-grade group had obviously lower CBV,PS and CBF than thehigh-grade group,and the difference had statistical significance(P<0.05).The low-grade group had rCBV as(1.81±0.43)and rCBF as(2.08±0.75)all<3.The high-grade group had rCBV as(5.69±1.79)and rCBF as(5.33±1.28)all>3.Conclusion CT perfusion imaging technique shows excellent effect for disease identificationand grading determination in preoperative diagnosis of brain glioma.It acts as a low-cost imaging diagnosismeasure with ideal diagnostic effect.