磁共振多模态影像在脑胶质瘤诊断分级中的应用价值研究

Application value of MRI multi-modal imaging in the diagnosis and grading of brain glioma

目的分析磁共振多模态影像在脑胶质瘤诊断分级中的应用价值。方法选取2018年2月至2020年9月我院脑胶质瘤患者84例,均行常规磁共振成像(MRI)、磁共振多模态影像[弥散张量成像(DTI)、磁共振波谱(MRS)、动脉自旋成像(ASL)]诊断,统计四者不同影像学表现及其单独、磁共振多模态影像检测脑胶质瘤分级正确率。结果脑胶质瘤患者84例均为单发,且其肿瘤位置分别位于幕上73例,幕下11例,其中额叶41例,顶叶23例,侧脑室后角部9例,小脑半球5例,小脑蚓部5例,第四脑室1例;病灶最大约9.5 cm×7.3 cm×6.5 cm,病灶最小约1.6 cm×1.4 cm×1.4 cm;混合性病灶14例,囊性病灶7例,实性病灶63例。低级别脑胶质瘤瘤周水肿优于高级别脑胶质瘤(χ^(2)=3.27,P<0.05);低级别脑胶质瘤患侧、患侧/健侧3D-ASL所得CBF较高级别脑胶质瘤低(t=32.34,t=21.89,P<0.01);低级别脑胶质瘤胆碱(Cho)/N-乙酰天冬氨酸(NAA)、Cho/肌酸(Cr)较高级别脑胶质瘤低,NAA/Cr较高级别脑胶质瘤高(t=10.63,t=8.04,t=8.23,P<0.01);低级别脑胶质瘤ADC、ADC比值较高级别脑胶质瘤高,FA、FA比值较高级别脑胶质瘤低(t=11.09,t=4.96,t=6.68,t=4.97,P<0.01);3种功能MRI诊断脑胶质瘤分级正确率97.6%(82/84)较常规MRI 59.5%(50/84)、MRS 83.4%(70/84)、DTI 67.9%(57/84)、ASL 76.2%(64/84)高(χ^(2)=40.43,P<0.01)。结论脑胶质瘤应用磁共振多模态影像诊断可获取更多病变组织影像学信息,且对脑胶质瘤分级更为准确,便于临床制订治疗方案。

Objective To analyze the application value of MRI multi-modal imaging in the diagnosis and grading of brain glioma.Methods A total of 84 patients with brain glioma in our hospital from February 2018 to September 2020 were selected and diagnosed by conventional magnetic resonance imaging(MRI)and MRI multi-modal imaging(DTI,MRS,ASL).The different imaging findings and the classification accuracy of single and MRI multi-modal imaging were analyzed.Results 84 cases with glioma were single.The tumors were located in supratentorial region(73 cases)and infratentorial region(11 cases),including 41 frontal lobe,23 parietal lobe,9 posterior horn of lateral ventricle,5 cerebellar hemisphere,5 vermis and 1 fourth ventricle.The largest lesion was about 9.5 cm×7.3 cm×6.5 cm,and the smallest lesion was about 1.6 cm×1.4 cm×1.4cm.There were 14 cases with mixed lesions,7 cases with cystic lesions,and 63 cases with solid lesions.Peritumoral edema of low-grade gliomas was better than that of high-grade gliomas(χ^(2)=3.27,P<0.05).The affected side/unaffected side of low-grade glioma was lower than that of high-grade glioma(t=32.34,t=21.89,P<0.01).The Cho/NAA、Cho/Cr of low-grade glioma were lower than those of high-grade glioma,and NAA/Cr was higher than that of high-grade glioma(t=10.63,t=8.04,t=8.23,P<0.01).The ADC、ADC ratio of low-grade glioma were higher than those of high-grade glioma,and FA、FA ratio were lower than those of high-grade glioma(t=11.09,t=4.96,t=6.68,t=4.97,P<0.01).The accuracy of three kinds MRI[97.6%(82/84)]in the diagnosis of glioma grading was higher than that of conventional MRI[MRI 59.5%(50/84)、MRS 83.4%(70/84)、DTI 67.9%(57/84)、ASL 76.2%(64/84)](χ^(2)=40.43,P<0.01).Conclusion The application of MRI multi-modal imaging in the diagnosis of brain glioma can obtain more information of pathological tissue imaging,and the grading of brain glioma is more accurate,which is convenient for clinical treatment.