弥散张量成像及氢质子磁共振波谱影像表现对颅脑高级别胶质瘤瘤周浸润的预测

Prediction of peritumoral invasion of high grade gliomas by diffusion tensor imaging and ^(1)H MRS

目的研究弥散张量成像(DTI)、氢质子磁共振波谱(^(1)H MRS)影像表现对颅脑胶质瘤的鉴别诊断及对高级别胶质瘤瘤周浸润的预测价值。方法采取前瞻性研究,以2017年2月~2020年1月在我院进行治疗的69例颅脑胶质瘤患者作为研究对象,根据世界卫生组织2007年中枢神经系统肿瘤的病理分期情况分析,低级别胶质瘤患者36例,高级别胶质瘤患者33例,比较两组患者的DTI、^(1)H MRS影像表现差异,分析DTI、^(1)H MRS联合诊断对高级别胶质瘤瘤周浸润的诊断价值。结果低级别胶质瘤患者的ADC显著高于高级别胶质瘤(t=4.480,P<0.001);在肿瘤组织中,低级别胶质瘤患者的NAA/Cr(t=8.477,P<0.001)、Cho/Cr(t=5.851,P<0.001)、Lip+Lac/Cr(t=19.141,P<0.001)低于高级别胶质瘤患者,Cho/NAA(t=2.493,P=0.015)高于高级别胶质瘤患者;在瘤周组织中,低级别胶质瘤患者的NAA/Cr(t=2.503,P=0.015)低于高级别胶质瘤患者,Cho/NAA(t=6.937,P<0.001)、Cho/Cr(t=14.267,P<0.001)、Lip+Lac/Cr(t=2.322,P=0.023)高于高级别胶质瘤患者;DTI、^(1)H MRS联合诊断对高级别胶质瘤患者的诊断灵敏度显著高于单独检测。结论DTI、^(1)H MRS影像表现对颅脑胶质瘤的鉴别诊断及对高级别胶质瘤瘤周浸润的预测效能较高,建议临床推广。

Objective To explore the value of diffusion tensor imaging(DTI)and^(1)H MRS in the differential diagnosis of brain gliomas and in the prediction of peritumoral invasion of high-grade gliomas.Methods In this prospective study,69 patients with brain glioma who were treated in our hospital from February 2017 to January 2020 were selected.According to the pathological staging of central nervous system tumor of who in 2007,there were 36 patients with low-grade glioma and 33 patients with high-grade glioma.The DTI and^(1)H of the two groups were compared to analyze the diagnostic value of DTI and^(1)H MRS in the diagnosis of peritumoral infiltration of high-grade gliomas.Result ADC of low-grade gliomas was significantly higher than that of high-grade gliomas(t=4.480,P<0.001).NAA/Cr(t=8.477,P<0.001),CHO/Cr(t=5.851,P<0.001)and Lip+Lac/Cr(t=19.141,P<0.001)of low-grade gliomas were significantly lower than those of high-grade gliomas.CHO/NAA(t=2.493,P=0.015)of low-grade gliomas were significantly higher than those of high-grade gliomas In tissues.NAA/Cr(t=2.503,P=0.015)of low-grade glioma patients was significantly lower than that of high-grade glioma patients,CHO/NAA(t=6.937,P<0.001),CHO/Cr(t=14.267,P<0.001)and lip+Lac/Cr(t=2.322,P=0.023)of low-grade glioma patients were significantly higher than that of high-grade glioma patients;the diagnostic sensitivity of DTI and^(1)H MRS combined diagnosis was significantly higher than that of single detection.Conclusion DTI,^(1)H MRS imaging performance of brain glioma in the differential diagnosis and high-grade glioma peritumoral infiltration of high-grade predictive efficiency,it is recommended that clinical promotion.