全脑灌注在脑胶质瘤边界区分中的应用价值

Application value of the whole-brain perfusion imaging on differentiating the border of glioma

目的探讨全脑灌注在脑胶质瘤边界区分中的应用价值。方法回顾性分析30例脑胶质瘤病例资料,低级别组(WHOⅠ~Ⅱ级)14例,高级别组(WHOⅢ~Ⅳ级)16例,均行全脑灌注扫描,测量CT增强与CT灌注上影像边界并求出面积,并在全脑灌注图显示的边界区、CT灌注边界外围区和健侧正常脑组织划定兴趣区,测量CBV。结果 CT灌注面积大于CT增强面积,差异有统计学意义(P<0.05)。高级别、低级别取边界参考值,CBV差异有统计学意义,rCBV差异无统计学意义。低级别胶质瘤以CBV 1.770 0mL/100g为CT灌注边界截点时,灵敏度85.71%,特异度78.57%。高级别胶质瘤以CBV值2.275 0mL/100g作为判断CT灌注边界截点时,灵敏度93.75%,特异度93.75%。高、低级别都以rCBV为1.025 0为判断CT灌注边界截点,灵敏度93.33%,特异度83.33%。结论全脑灌注成像在胶质瘤边界区分有较高的临床应用价值。

Objective To discuss the application value of the whole-brain perfusion imaging on differentiating the border of glioma.Methods The clinical data of 30 patients with glioma were retrospectively analyzed.All patients were divided into low-grade group(WHO gradeⅠ?Ⅱ,n=14)and high-grade group(WHO grade Ⅲ-Ⅳ,n=16).The whole-brain perfusion scanning was performed to measure the imaging boundaries presented by contrast-enhanced CT and by CT perfusion in order to calculate the area.In addition,the CBVs of the border area displayed from the whole-brain perfusion graph,the boundary peripheral region traced by CT perfusion and the normal brain tissue in the uninjured side were measured.Results The area of the tumor acquired from CT perfusion was significantly larger than that from contrast-enhanced CT,and the difference was statistically significant(P<0.05).CBV showed significant difference while rCBV had no difference in terms of marginal reference value of low-grade and high-grade groups.When we regarded CBV value of 1.770 0mL/100 g as marginal cut-off point presented by CT perfusion in the low-grade group,the sensitivity was 85.71% and the specificity was 78.57%.When the CBV value of 2.275 0mL/100 g was determined as cut-off point in the high-grade group,the sensitivity was 93.75% and the specificity was 93.75%.In both two groups,the cut-off point of the rCBV value of 1.025 0indicated that the sensitivity was93.33% and the specificity was 83.33%.Conclusion Whole-brain perfusion imaging has a clinical effect on differentiating the border of gliomas.