【摘要】 目的 探讨MR动态磁敏感灌注加权成像(DSC-PWI)在星形细胞瘤分级及与单发脑转移瘤鉴别诊断中的价值。方法对病理证实的18例星形细胞瘤、14例脑转移瘤患者行常规MRI及DSC-PWI检查。分别测量脑肿瘤实质及瘤周区的平均局部脑血容量(rCBV)值、局部脑血流量(rCBF)值、局部平均通过时间(rMTT)和局部达峰时间(rTTP)。肿瘤不同区域之间、星形细胞瘤不同级别之间、星形细胞瘤与转移瘤之间的灌注参数差异采用单因素方差分析。对于肿瘤间有统计学差异的参数,采用受试者工作特征曲线(ROC)分析其诊断效能。结果 高级别星形细胞瘤实质、近侧瘤周区和远侧瘤周区rCBV值具有显著性差异;瘤内实质rCBF值明显高于近瘤区。高级别星形细胞实质rCBV值和rCBF值均明显高于低级别星形细胞瘤,rTTP值明显低于低级别星形细胞瘤。以rCBV值1.45为阈值鉴别高、低级别星形细胞瘤,ROC曲线下面积(AUC)为0.792。转移瘤实质的rTTP高于星形细胞瘤;高级别星形细胞瘤的近瘤区rTTP、远瘤区rCBF低于转移瘤;低级别星形细胞瘤实质rTTP低于转移瘤。结论 DSCPWI能够定量评估肿瘤实质和瘤周微循环状态。更多还原

【Abstract】 Objective To explore the value of the dynamic susceptibility contrasted perfusion weighted imaging(DSC-PWI) in grading of astrocytomas and in differentiation of astrocytomas and metastases.Methods 32 patients of solitary metastases and astrocytomas underwent conventional MRI examinations and DSC-PWI.The mean values of DSC-PWI parameters(rCBV,rCBF,rMTT and rTTP)in the solid part of tumor and the peripheral region around tumor were obtained.The DSC-PWI parameters were compared among the different tumor regions and then between the tumor grades,astrocytomas and metastases with One-Way ANOVA variance.ROC was used to determine the differentiation ability of DSC-PWI parameters for astrocytoma grading and differentiation of astrocytomas and metastases.Results In high-grade astrocytomas,significant difference was observed in the mean rCBV values among solid part,APR and DPR,and the mean rCBF value in solid part was markedly higher than that in APR.The mean rCBV and rCBF values of high-grade astrocytomas exhibited in increased manner in the solid part of tumors comparing with the low-grade tumors.Mean rTTP value of the high-grade was decreased significantly versus the low-grade.AUC was 0.792 in differentiating the low-and high-grade astrocytomas.The value of rTTP in metastases parenchyma was higher than that of the low-grade astrocytomas.In tumor APR,the mean rTTP value of high-grade astrocytomas was significantly lower than the metastases.In tumor DPR,the mean rCBF value of high-grade astrocytomas was lower than the metastases.Conclusion DSCPWI can be a kind of quantitative method for assessing the blood supply of tumors.更多还原