【摘要】 目的 探讨3.0T磁共振定量动态对比增强（DCEMRI）渗透性参数鉴别高级别脑胶质瘤（HGG）和单发脑转移瘤的价值。方法 回顾性分析18例HGG和21例单发脑转移瘤患者的DCEMRI资料，分别测量瘤体区和瘤周水肿区的渗透性参数的最大值，即转运常数(K^trans)、细胞外血管外间隙的体积百分数（V_e）、回流常数(K_ep)和血浆体积百分数（V_p）。以t检验比较HGG和单发脑转移瘤的各参数最大值的组间差异，采用受试者工作特征曲线（ROC）分析渗透性参数的阈值、敏感性、特异性和曲线下面积（AUC）。结果 HGG和单发脑转移瘤瘤周水肿区的K^trans和K_ep分别为（0.018±0.013） min^-1、（0.575±0.239） min^-1和（0.007±0.008） min^-1、（0.349±0.313）min^-1,组间差异有统计学意义（t=3.089,2.495,P<0.05）,而其他渗透性参数组间差异均无统计学意义（P>0.05）。ROC分析显示K^transe值鉴别诊断脑胶质瘤的曲线下面积（AUC）最大（AUC=0.820）,敏感性和特异性分别为94.4%和71.4%。结论 DCEMRI在瘤周水肿区的渗透性参数(K^transe)有助于HGG和单发脑转移瘤的鉴别诊断。更多还原

【Abstract】 Objective To investigate the diagnostic value of 3.0T MRI dynamic contrast-enhanced（DCE-MRI） for differentiating high grade gliomas（HGG） from brain metastasis.Methods The DEC-MRI data of 18 patients with gliomas and 21 patients with brain metastasis were reviewed retrospectively.The values of volume transfer constant(K^trans),volume fraction of extracellular space（V_e）,reflux constant(K_ep) and fractional plasma volume（V_p） were calculated in the tumor and peritumoral edema by pharmacokinetic model.t test was used to calculate the statistical significance between HGG and brain metastasis.Receiver operating characteristic（ROC） curve analysis was performed for evaluating the sensitivity,specificity and AUC.Results The K^trans and K_ep value in the peritumoral edema were（0.018±0.013） min^-1 vs.（0.007±0.008） min^-1,and（0.575±0.239） min^-1 vs.（0.349±0.313） min-1 between HGG and brain metastasis,and the differences were statistically significant（t=3.089,2.495,P<0.05）.The other permeability parameters were not statistically significant（P>0.05）.ROC curve analysis showed the AUC value of K^trens was the highest（AUC=0.820） with the sensitivity of 94.4% and the specificity of 71.4%.Conclusion Permeability parameter of K^trans in the peritumoral edema is help to differentiating between HGG and brain metastasis by DCE-MRI.更多还原