摘要
目的比较三维动脉自旋标记成像(3D-ASL)和动态磁敏感对比(DSC)增强灌注成像在神经上皮肿瘤分级中的诊断准确性。方法对38例经病理证实的神经上皮肿瘤术前行3D-ASL及DSC灌注成像。根据CBF图及rCBF图,测量肿瘤区最大CBF值及正常小脑白质区CBF值并求比值(nCBF),同样的方法测量nrCBF值,按照病理结果分高、低级别组进行相应参数的统计学分析。结果低级别肿瘤组平均nCBF值(1.891±1.536)明显低于高级别肿瘤组(4.269±2.212)(P<0.05)。低级别肿瘤组平均nrCBF值(1.538±1.178)明显低于高级别肿瘤组(6.674±4.139)(P<0.05)。肿瘤nCBF与nrCBF值存在明显正相关,相关系数为0.561(P<0.0001),以nCBF值2.364和nrCBF值3.037作为阈值,可分别达到88.2﹪、94.1﹪的诊断敏感性,80.9﹪、90.5﹪的特异性和84.2﹪、92.1﹪的准确性。结论由于诸多内在的优势,3D-ASL可以用于评价肿瘤微血管灌注情况,能够明确区分高级别与低级别神经上皮肿瘤,可作为替代DSC的优先选择方法。
Objective To compare the diagnostic accuracy of 3-dimensional arterial spin labeling （3D-ASL） and dynamic susceptibility contrast （DSC） enhancement perfusion in the prediction of neuroepithe｜ial tumors grading. Methods 38 patients with pathologically proved neuroepithelial tumors underwent 3D-ASL and DSC perfusion MR imaging. Representative maximal nCBF from 3D-ASL and nrCBF from DSC were measured. Results The mean nCBF ratio （1.891 ± 1.536） of low grade tumor group was lower than that （4.269 ± 2.212） of high grade tumor group （P 〈 0.05）. The mean nrCBF ratio （1.538 ± 1.178） of low trade tumor group was lower than that （6.674 ± 4. 139） of high grade tumor group （P 〈 0.05）. There was a positive correlation between nCBF and nrCBF in the tumor region of interest （linear regression coefficient, r = 0.56 l; P 〈 0.0001）. The cutoff nCBF ratio of 2.364 and nrCBF ratio of 3.037 for the differentiation between high and low grade neuroepithelial tumors provided the best combination of sensitivity （88.2 %, 94.1% ）, specificity （80.9 %, 90.5 %）, and accuracy （84.2 %, 92.1%）, respectively. Conclusion 3D-ASL is an alternative method of DSC for assessment of microvascular perfusion and allows distinction between high and low grade neuroepithelial tumors.
出处
《功能与分子医学影像学（电子版）》
2013年第2期12-14,共3页
Functional and Molecular Medical Imaging(Electronic Edition)
