多模态MRI影像对胶质瘤患者诊断和分级的应用价值
高兴锋
摘要(Abstract)：
目的探讨多模态MRI影像对胶质瘤患者诊断和分级的临床应用价值。方法对84例胶质瘤患者行常规平扫、增强扫描和DTI成像,分析病灶的影像表现。分别测量肿瘤瘤体部分和瘤周水肿带的rFA、rADC值,比较不同级别肿瘤间、同级别肿瘤内的差异,并分析rFA、rADC值与病理分级的相关性。通过DDT观察纤维束的形态变化。结果 2组肿瘤瘤体部分和瘤周水肿带的rFA值差异无统计学意义(P>0.05),2组肿瘤瘤体部分和瘤周水肿带的rADC值差异有统计学意义(P<0.05),且低级别胶质瘤的rADC值高于高级别胶质瘤患者同部位的rADC值;对2组的组内rADC、rFA值比较,肿瘤瘤体部分和瘤周水肿部分的rADC、rFA值差异均有统计学意义(P<0.05),且瘤周水肿部分的rADC、rFA值高于肿瘤瘤体部分的rADC、rFA值。rADC值与病理分级相关,相关系数为-0.722。结论 rADC值的测定有助于对胶质瘤的诊断和分级,多模态MRI影像对胶质瘤患者诊断和分级的有重要的临床价值。
关键词(KeyWords)： 胶质瘤;磁共振成像;扩散张量成像;诊断;分级
基金项目(Foundation):
作者(Author): 高兴锋
参考文献(References)：
- [1]Dolecek TA,Propp JM,Stroup NE,et al.CBTRUS Statistical report:primary brain tunlors and central nervous system tumors diagnosed in the united states in 2005-2009[J].Neuro Oncol,2012,14(5):21-49.
- [2]Nishi N,Kawai S,Yonezawa T,et al.Early appearance of high grade glioma on magnetic resonance imaging[J].Neuro Med Chir(Tokyo),2009,49(1):8-12.
- [3]胡鸿博,刘鹏飞.磁共振弥散张量成像及纤维束成像对脑胶质瘤分级的诊断价值[J].磁共振成像,2011,2(2):118-122.
- [4]Muthusami P,Basti RS,Thomas B,et al.Glioma progression as revealed by diffusion tensor metrics[J].Neurol India,2012,60(3):355-357.
- [5]Lee HY,Na DG,Song IC,et a1.Diffusion-tensor imaging for glioma grading at 3-T magnetic resonance imaging:analysis of fractional anisotropy and mean diffusivity[J].J Comput Assist Tomogr,2008,32(2):298-303.
- [6]Kalleberg K,Goldmann T,Menke J.Glioma infiltration of the corpus callosum:early signs detected by DTI[J].J Nenrooncol,2013,112(2):217-222.
- [7]Piyapittayanan S,Chawalparit O,Tritakarn SO,et al.Value of diffusion tensor imaging in differentiating high-grade from lowgrade gliomas[J].J Med Assoc Thai,2013,96(6):716-21.
- [8]Li SW,Tian SY,Li ZX,et a1.Application of diffusion tensor imaging in the preoperative grading of astrocytoma[J].Radiology Practice,2007,22(4):234-237.
- [9]LEE E J,LEE S K,AGID R,et al.Preoperative grading of presumptive low-grade astrocytomas on MR imaging:Diagnostic value of minimum apparent diffusion coefficient[J].AJNR Am J Neuroradiol,2008,29(10):1 872-1 877.
- [10]Chen Y,Shi Y,Song Z.Differences in the architecture of lowgrade and high-grade gliomas evaluated using fiber density index and fractional anisotropy[J].J Clin Neurosci,2010,17(7):824-829.