摘要
目的 探讨动态增强MRI（DCE-MRI）的定性、半定量、定量参数在垂体腺瘤诊断中的应用价值.方法 采用回顾性病例对照研究方法,收集2014年8月—2018年3月蚌埠医学院第一附属医院收治的23例垂体腺瘤患者的临床和影像资料,均经临床及病理等确诊,男9例、女14例,年龄29～70岁;其中垂体微腺瘤9例（垂体微腺瘤组）、垂体大腺瘤14例（垂体大腺瘤组）;选取8例常规颅脑检查垂体正常者作为对照组,男3例、女5例,年龄28～67岁.研究对象均行DCE-MRI,获得感兴趣区域的时间-信号强度曲线（TIC）进行分型定性分析,并测量DCE-MRI半定量参数达峰时间（TTP）、最大上升斜率（MSI）和定量参数容积转运常数（Ktrans）、回流速率常数（Kep）值,采用单因素方差分析及Kruskal-Wallis检验进行组间比较.结果 垂体微腺瘤组TICⅠ、Ⅱ、Ⅲ型分别为0、7、2例,垂体大腺瘤组分别为10、3、1例,对照组分别为7、1、0例,差异有统计学意义（Z=11.346,P〈0.01）;对照组与垂体微腺瘤组、垂体微腺瘤组与垂体大腺瘤组比较,差异均有统计学意义（P值均〈0.05）.对照组的TTP[（48.52±15.83）s]小于垂体微腺瘤组[（80.79±19.32）s]和垂体大腺瘤组[（70.42±21.64）s],MSI（3.92％ ±1.24％）及Ktrans[（1.08±0.22）min-1]、Kep[（1.34±0.40）min-1]值均大于垂体微腺瘤组[1.89％ ±1.04％、（0.45±0.18）min-1、（0.86±0.22）min-1]和垂体大腺瘤组[2.79％ ±1.06％、（0.69±0.28）min-1、（0.95±0.28）min-1],差异均有统计学意义（P值均〈0.05）;垂体大腺瘤组MSI、Ktrans均大于垂体微腺瘤组,差异均有统计学意义（P值均〈0.05）.结论DCE-MRI中TIC曲线可以鉴别垂体腺瘤,半定量参数TTP、MSI和定量参数Ktrans、Kep能够进一步诊断垂体微腺瘤;MSI、Ktrans能够鉴别垂体微腺瘤和大腺瘤.
Objective To explore the application value of qualitative, semi-quantitative and quantitative parameters in dynamic enhanced MRI （ DCE-MRI ） in the diagnosis of pituitary adenoma. Methods The retrospective case-control study was conducted. The pituitary adenomas were collected in the First Affiliated Hospital of Bengbu Medical College from August 2014 to March 2018. Twenty-three cases of pituitary adenomas confirmed by clinical and pathological diagnosis were examined by DCE-MRI, including 9 males and 14 females with age of 29 -70 years. Among them, there were 9 cases of microadenoma （ microadenoma group ） and 14 cases of macroadenoma （ macroadenoma group ） . Eight cases of normal pituitary were selected as a control group, including 3 males and 5 females with ages of 28-67 years. Then obtain time-signal intensity curve （ TIC ） of these cases which consequently were classification and qualitatively analyzed. The time to peak （ TTP ） , maximum slope of increase （ MSI ） , volume transfer constant （ Ktrans ） and exchange rate constant （ Kep ） were measured. The single factor variance analysis and Kruskal-Wallis test were used for the above parameter. Results The number of microadenomas TIC three types of curves were 0, 7, 2;macroadenoma were 10, 3, 1;normal pituitary were 7, 1, 0. Difference was statistically significant（Z=11. 346, P〈0. 01）. Compared with other three groups, the TIC types in the control group were significantly different （all P values〈0. 05）. The values of TTP [（48. 52 ± 15. 83）s] with control group less than the microadenoma group [（80. 79 ± 19. 32） s] and macroadenoma group [（70.42±21.64）s]; MSI（3.92% ±1.24%）, Ktrans[（1.08 ±0.22）min-1] and Kep[（1.34 ± 0.40）min-1] of control group higher than microadenoma group [1.89% ±1.04%,（0.45 ±0.18）min-1, （0. 86 ± 0. 22）min-1] and macroadenoma group [2. 79% ± 1. 06%, （0. 69 ± 0. 28） min-1, （0. 95 ±0. 28）min-1], the differences were statistically significant（all P values〈0. 05）. The MSI and Ktrans values of macroadenoma were higher than those of microadenomas, the differences were statistically significant（ all P values〈0. 05）. Conclusions The TIC types can be used in differential diagnosis of pituitary adenoma. The TTP, MSI, Ktrans and Kep parameters can be further used to diagnose microadenomas. The parameters of Slopemax and Ktrans can be used in differential diagnosis of microadenoma and macroadenoma.
作者
马宜传
谢宗玉
Ma Yichuan;Xie Zongyu(Department of Radiology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)
出处
《中华解剖与临床杂志》
2018年第4期288-292,共5页
Chinese Journal of Anatomy and Clinics
基金
安徽省高校自然科学研究重点项目（KJ2018A0225）
关键词
垂体肿瘤
腺瘤
磁共振成像
动态增强扫描
Pituitary neoplasms
Adenoma
Magnetic resonance imaging
Dynamic contrast- enhanced scan
