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1、DOI：10.16016/j.1000-5404.201410173DSC-MRI和DCE-MRI定量分析在腦膠質(zhì)瘤分級(jí)診斷中的應(yīng)用黃杰，李曉光，康厚藝，張玉龍，張偉國(guó)（400042重慶，第三軍醫(yī)大學(xué)大坪醫(yī)院野戰(zhàn)外科研究所放射科）[摘要]目的定量分析T1加權(quán)動(dòng)態(tài)對(duì)比增強(qiáng)成像(DCE-MRI)中的參數(shù)(Ktrans、Ve)和T2*加權(quán)動(dòng)態(tài)磁敏感增強(qiáng)灌注成像（DSC-MRI）中的參數(shù)（rCBV、rCBF）與腫瘤病理分級(jí)的相關(guān)性，比較DCE-MRI及DSC-MRI參數(shù)在腦膠質(zhì)瘤分級(jí)診斷中的價(jià)值。方法病理證實(shí)的
2、85例腦膠質(zhì)瘤患者，低級(jí)別膠質(zhì)瘤36例，高級(jí)別膠質(zhì)瘤49例?；颊咴谛g(shù)前行DCE-MRI成像或/和DSC-MRI成像，以相應(yīng)后處理軟件獲得灌注參數(shù)值。采用單因素方差分析比較不同級(jí)別膠質(zhì)瘤Ktrans與Ve值及rCBV與rCBF值與腫瘤病理分級(jí)的差異，應(yīng)用Pearson相關(guān)系數(shù)分析Ktrans、Ve值及rCBV、rCBF值與膠質(zhì)瘤級(jí)別之間的相關(guān)性。應(yīng)用ROC曲線分析獲得Ktrans、Ve值及rCBV與rCBF值鑒別不同級(jí)別膠質(zhì)瘤的最佳閾值及其敏感性和特異性。結(jié)果高級(jí)別膠質(zhì)瘤的平均Ktrans及Ve值均顯著高
3、于低級(jí)別膠質(zhì)瘤（分別為0.157±0.177/min-1vs0.029±0.020/min-1；0.601±0.246vs0.118±0.062，P<0.01）。當(dāng)Ktrans=0.055/min-1時(shí)其診斷敏感性及特異性分別為89.7%和90.5%，當(dāng)Ve=0.343時(shí)其診斷敏感性及特異性分別為86.2%和85.7%。高級(jí)別膠質(zhì)瘤的平均rCBV及rCBF值均顯著高于低級(jí)別膠質(zhì)瘤（2.649±1.351vs1.480±0.391；2.427±1.248vs1.377±0.545，P<0.01）。當(dāng)rCB
4、V=2.043時(shí)其診斷敏感性及特異性分別95.2%和92.9%，當(dāng)rCBF=1.886時(shí)其診斷敏感性及特異性分別為85.7%和85.7%。結(jié)論Ktrans與Ve值，rCBV與rCBF值用于腦膠質(zhì)瘤分級(jí)均具有較強(qiáng)相關(guān)性，而rCBV是敏感性及特異性最高的參數(shù)，其次是Ktrans、Ve和rCBF。[關(guān)鍵詞]膠質(zhì)瘤；動(dòng)態(tài)對(duì)比增強(qiáng)灌注成像；動(dòng)態(tài)磁敏感增強(qiáng)灌注成像[中圖法分類號(hào)][文獻(xiàn)標(biāo)志碼]ADynamiccontrastenhancedmagneticresonanceimaginganddynamicsusc
5、eptibilitycontrastmagneticresonanceimagingingradingofgliomaHuangJie,LiXiaoguang,KangHouyi,ZhangYulong,ZhangWeiguo(DepartmentofRadiology,InstituteofSurgeryResearch,DapingHospital,ThirdMilitaryMedicalUniversity,Chongqing,400042,China)[Abstract]Objective:To
6、analyzethecorrelationoftheparametersderivedfromdynamiccontrastenhancedmagneticresonanceimaging(DCE-MRI),Ktrans(volumetransferconstant)andVe(volumefractionofextravascularextracellularspace),andthosefromdynamicsusceptibilitycontrastmagneticresonanceimaging
7、(DSC-MRI),rCBV(relativecerebralbloodvolume)andrCBF(relativecerebralbloodflow)withthegradesofglioma,andcomparethevaluesoftheparametersinthegrading.Methods:Atotalof85patientswithdifferenttypesofpathologicallyconfirmedgliomas,including39withlowgradegliomas(
8、LGGs)and46withhighgradegliomas(HGGs).firstlydiagnosedinourhospitalfromSeptember2013toSeptember2014wereenrolledinthisstudy.DSCMRIand/orDCE-MRIwereperformedonthepatientsbeforesurgery,andthecorrespondingperfusionparameterswer
