磁共振、MSCT灌注成像对恶性脑胶质瘤的诊断及预后评估价值

Diagnostic and Prognostic Evaluation Value of Magnetic Resonance and MSCT Perfusion Imaging for Malignant Glioma

目的分析磁共振灌注成像(PWI)、多层螺旋CT(MSCT)灌注成像对恶性脑胶质瘤的诊断及预后评估价值。方法选取2020年7月至2021年7月清丰第一医院收治的62例疑似恶性脑胶质瘤患者,均接受PWI和MSCT灌注成像检查,以病理检查为金标准,比较PWI、MSCT灌注成像对恶性脑胶质瘤的诊断价值,比较不同级别脑胶质瘤患者和经调强适形放疗的恶性脑胶质瘤不同预后患者PWI、MSCT灌注成像参数,分析PWI、MSCT灌注成像参数对恶性脑胶质瘤患者的预后评估价值。结果病理诊断高级别脑胶质瘤22例,低级别35例,阴性5例,PWI诊断恶性胶质瘤灵敏度、特异度高于MSCT灌注成像诊断,差异有统计学意义(P<0.05)。恶性脑胶质瘤相对局部脑血容量(rCBV)、相对脑血流量(rCBF)、相对表面通透性(rPS)值均高于低级别脑胶质瘤和脑胶质瘤阴性患者,差异有统计学意义(P<0.05);22例恶性脑胶质瘤经调强适形放疗并随访1年后,生存15例(68.18%)、死亡7例(31.82%);生存组rCBV、rCBF、rPS值均低于死亡组,差异有统计学意义(P<0.05),同时rCBV、rCBF、rPS及联合对恶性脑胶质瘤的AUC分别为0.776、0.962、0.810、1.000。结论PWI灌注成像对恶性脑胶质瘤的诊断价值优于MSCT灌注成像,rCBV、rCBF、rPS对恶性脑胶质瘤患者的预后评估有一定意义。

Objective To analyze the value of magnetic resonance perfusion imaging(PWI)and multilayer spiral CT(MSCT)perfusion imaging for the diagnosis and prognostic evaluation of malignant glioma.Methods A total of sixty-two patients with suspected malignant glioma admitted to Qingfeng Firs hospital from July 2020 to July 2021 were selected and all received PWI and MSCT perfusion imaging to compare the diagnostic value of PWI and MSCT perfusion imaging for malignant glioma using pathological examination as the gold standard,and to compare the PWI and MSCT perfusion imaging parameters in patients with different grades of glioma and different prognosis of malignant glioma treated with intensity-modulated conformal radiotherapy,and to analyze the prognostic assessment value of PWI and MSCT perfusion imaging parameters in patients with malignant glioma.Results Pathological diagnosis of high-grade glioma was found in 22 cases,low-grade gliomas in 35 cases,negative in 5 cases,PWI diagnosis of malignant glioma sensitivity and specificity than MSCT perfusion imaging diagnosis,the difference was statistically significant(P<0.05).Relative local cerebral blood volume(rCBV),relative cerebral blood flow(rCBF),and relative surface permeability(rPS)values were higher in malignant glioma than in low-grade glioma and glioma-negative patients,the difference was statistically significant(P<0.05);after 22 malignant gliomas were treated with intensity-modulated conformal radiotherapy and followed up for 1 year,15 cases(68.18%)survived and 7 cases(31.82%)died;the rCBV,rCBF,and rPS values were lower in the survival group than in the death group(P<0.05),while the AUCs of rCBV,rCBF,rPS,and combination for malignant gliomas were 0.776,0.962,0.810 and 1.000.Conclusions The diagnostic value of PWI perfusion imaging is better than MSCT perfusion imaging for malignant glioma,rCBV,rCBF,and rPS are meaningful for prognostic assessment of patients with malignant glioma.