磁共振成像在脑胶质瘤分级鉴别诊断中的应用价值

Application Value of Magnetic Resonance Imaging in Differential Diagnosis of Glioma

目的:探讨磁共振成像在脑胶质瘤分级鉴别诊断中的应用价值。方法:选取2016年6月-2021年6月诊治的96例脑胶质瘤患者,根据脑胶质瘤不同级别进行分为两组,分别为56例和40例,使用西门子公司生产的Skyra3.0 T磁共振成像设备,对患者行颅脑横轴位T1WI、T2WI、T2_FLAIR、DWI,矢状位T1WI磁共振平扫和横轴位、冠状位、矢状位增强扫描,并做氢质子磁共振波谱图像分析。结果:56例低级别脑胶质瘤组中ADC高信号十分明显,DWI等信号25例,DWI高信号31例,40例高级胶质瘤ADC低信号十分明显,DWI等信号12例,DWI高信号28例。高级别脑胶质瘤磁共振波谱代谢产物比值:两组N-乙酰天门冬氨酸/肌酸比较,差异无统计学意义(P>0.05);胆碱/肌酸和胆碱/N-乙酰天门冬氨酸高于对照组,差异有统计学意义(P<0.05)。高级别脑胶质瘤组患者病灶边界、平扫信号不均、占位效应、区域水肿、囊变、坏死、肿瘤强化体积、是否接触脑室下区方面明显重于低级别脑胶质瘤组,差异有统计学意义(P<0.05)。结论:低级别脑胶质瘤组中ADC高信号十分明显,高级胶质瘤ADC低信号明显,不同级别的脑胶质瘤患者胆碱/肌酸和胆碱/N-乙酰天门冬氨酸也存在较大的差异,脑胶质瘤组患者病灶边界、平扫信号不均、占位效应、区域水肿、囊变、坏死、肿瘤强化体积及是否接触脑室下区是区分颅脑胶质瘤患者级别的重要因素,磁共振成像可以鉴别颅脑胶质瘤患者级别,有助于指导临床选择合理的治疗方案并预测预后。

Objective:To investigate the application value of magnetic resonance imaging in differential diagnosis of glioma.Methods: A total of 96 patients with glioma diagnosed and treated from June 2016 to June 2021 were selected and divided into two groups according to different grades of glioma, including 56 cases and 40 cases, respectively. Skyra 3.0T magnetic resonance imaging equipment produced by Siemens was used. The patients underwent transverse T1WI, T2WI, T2_FLAIR, DWI, sagittal T1WI plain MRI, and transverse, coronal and sagittal enhanced MRI, as well as hydrogen proton magnetic resonance spectrum image analysis. Results: In the 56 cases of low-grade glioma group, ADC high signal was obvious, DWI equal signal was found in25 cases, DWI high signal was found in 31 cases, ADC low signal was obvious in 40 cases of high-grade glioma, DWI equal signal was found in 12 cases, DWI high signal was found in 28 cases. The ratio of metabolites in MRI spectrum of high-grade glioma:There was no significant difference in N-acetylaspartate/creatine between the two groups(P>0.05);the ratio of choline/creatine and choline/N-acetylaspartate was higher than that in the control group, and the difference was statistically significant(P<0.05).The lesion boundary, uneven signal on plain scan, mass effect, regional edema, cystic degeneration, necrosis, tumor enhancement volume and whether in contact with subventricular area were significantly heavier in high-grade glioma group than in low-grade glioma group, and the difference was statistically significant(P<0.05). Conclusion: The ADC high signal is obvious in low-grade glioma group, and the ADC low signal is obvious in high-grade glioma group. There are also significant differences in choline/creatine and choline/N-acetylaspartic acid among patients with different grades of glioma. Glioma patient’s lesion boundary,uneven signal on plain scan, mass effect, regional edema, cystic degeneration, necrosis, tumor enhancement volume, whether in contact with subventricular area are the important factors to distinguish the grade of cerebral glioma patients, magnetic resonance imaging can identify the grade of cerebral glioma patients, it helps guide the selection of clinically rational treatment regimen and predicts prognosis.