【摘要】 目的 :评价联合三维伪连续性动脉自旋标记磁共振灌注成像(3D p CASL)和扩散加权成像(DWI)技术在脑胶质瘤分级中的价值。方法 :对经手术切除病理证实的37例脑胶质瘤病人(19例高级别胶质瘤和18例低级别胶质瘤)在术前行磁共振3D p CASL、DWI和常规序列的扫描。将感兴趣区置于脑胶质瘤的实性部分并分别进行定量测量得到血流量(CBF)和表观扩散系数(ADC)值。分别比较CFB和ADC值在高、低级别脑胶质瘤中的差异。利用Binary逻辑回归和受试者特征曲线(ROC)分析CBF、ADC值和CBF联合ADC值在高、低级别脑胶质瘤分级中的价值。结果 :CBF值在高级别脑胶质瘤中(85.3±19.2 ml/min/100g)显著高于在低级别脑胶质瘤中(43.5±11.2 ml/min/100g)(P<0.01)。ADC值在高级别胶质瘤中(0.0009±0.0002mm2/s)显著低于在低级别脑胶质瘤中(0.0014±0.0004 mm2/s)(P<0.01)。ROC曲线分析显示,在对高、低级别脑胶质瘤的分级中,CBF联合ADC值的曲线下面积显著大于CBF或ADC值的(P<0.05),CBF联合ADC值的敏感性和特异性均大于单独使用CBF或ADC值。结论 :三维伪连续性动脉自旋标记灌注磁共振成像和扩散加权成像均有助于脑胶质瘤的分级。与单独使用CBF或ADC值相比,CBF联合ADC值可以显著提高对脑胶质瘤进行分级的能力。更多还原

【Abstract】 Purpose: To evaluate the diagnostic capability of the combination of 3D pseudocontinuous arterial spin labeling(p CASL) with diffusion weighted imaging(DWI) in grading gliomas. Methods: Nineteen cases of high-grade gliomas and 18 low-grade gliomas proved by pathology results were scanned on a 3.0T MR. 3D p CASL, DWI and routine MRI sequences were performed on all patients before surgery. The CBF values and ADC values of the ROIs, which were manually placed in solid parts of gliomas, were measured and compared between highgrade and low-grade gliomas. Binary logistic regression and receiver operating characteristic(ROC) curve analyses were used to assess the diagnostic efficiency of using CBF, ADC and combination of CBF with ADC. Results: The CBF values were significantly higher in high-grade(85.3±19.2 ml/min/100g) gliomas than that in low-grade gliomas(43.5±11.2 ml/min/100g)(p<0.01). The ADC values were significantly lower in high-grade gliomas(0.0009±0.0002 mm2/sec) than that in low-grade gliomas(0.0014±0.0004 mm2/sec)(p<0.01). The combination of CBF with ADC in grading gliomas had significantly larger area under the ROC curve than that CBF or ADC was used alone(p<0.05). The combination of CBF with ADC demonstrated superior sensitivity and specificity as compared with that CBF or ADC was used alone for grading gliomas. Conclusion: 3D p CASL MRI and DWI are useful tools in the grading of gliomas. The combination of CBF with ADC improves the prediction of glioma grade as compared to CBF or ADC used alone.更多还原