【摘要】 目的探讨颅内肿瘤大剂量Gd-DTPA MR灌注成像的应用价值及安全性。方法收集经病理证实的颅内肿瘤36例,其中低级别胶质瘤(Ⅰ~Ⅱ级)15例,高级别胶质瘤(Ⅲ~Ⅳ级)12例,脑膜瘤7例,胆脂瘤1例,脉络丛乳头状瘤1例,使用FID-EPI序列行Gd-DTPA灌注成像。在脑血流容积的伪彩色图像上测得肿瘤的rCBV值,并对各组肿瘤的rCBV值进行统计学t检验;记录注药后患者的表现及不良反应,评价大剂量Gd-DTPA灌注的安全性。结果低级别胶质瘤与高级别胶质瘤的rCBV值,低级别胶质瘤与脑膜瘤的rCBV值比较有统计学意义(P<0.05),而高级别胶质瘤与脑膜瘤的rCBV值比较没有统计学意义(P>0.05)。1例脉络丛乳头状瘤的rCBV值为9.15,表现为高灌注;1例胆脂瘤的rCBV值为0.09,表现为低灌注;36例灌注患者未见药物过敏反应。结论大剂量Gd-DTPA的MR灌注成像有助于脑胶质瘤的分级及与其他颅内肿瘤的鉴别诊断,临床应用的安全性良好。更多还原

【Abstract】 Objective To study the value and safety of perfusion-weighted MR imaging with large dose of Gd-DTPA in the diagnosis of intracranial tumors.Methods MR PWI with FID-EPI sequence was performed in 36 patients with intracranial tumors,including 15 cases of low-grade(grade Ⅰ-Ⅱ) glioma,12 cases with highgrade(grade Ⅲ-Ⅳ) glioma,7 cases with meningioma,one case with cholesteatoma and one case with choroid plexus papilloma.The tumors’ rCBV were measured on the pseudo-color images of CBV,which were undertook t test.The safty of PWI with large dose of Gd-DTPA was evaluated by writing down the appearances of patients and adverse reactions of Gd-DTPA.Results The difference of rCBV between low-grade gliomas and high-grade gliomas,meningiomas were statistically significant(P<0.05).However,the rCBV between high-grade glimoas and meningiomas showed no statistic difference(P>0.05).One choroid plexus papilloma and one cholesteatoma showed hypertransfusion(9.15) and hypoperfusion(0.09) respectively.No allergic reactions of drug occurred in 36 patients.Conclusion PWI with large dose of Gd-DTPA is helpful in grading gliomas and differential diagnosis of intracranial tumors,which is safe in clinic application.更多还原