ASL联合MRS鉴别恶性胶质瘤真假性进展应用价值被引量：9

The Value of Combination of ASL and MRS for Differentiating True Progression from Pseudo-progression of Malignant Glioma

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摘要目的:探讨动脉自旋标记(ASL)联合磁共振波谱(MRS)在恶性胶质瘤真假性进展鉴别诊断价值。方法:回顾性分析兰州大学第二医院2015年1月-2017年7月22例恶性胶质瘤术后放疗患者的临床及影像资料,其中肿瘤真性进展15例,假性进展7例。比较异常强化区与对侧正常区的脑血流量(r CBF)、胆碱(Cho)/磷酸肌酸(Cr)比值、N-乙酰天冬氨酸(NAA)/磷酸肌酸(Cr)比值。结果:肿瘤真性进展组ASL呈高灌注,MRS示Cho/Cr比值升高及NAA/Cr比值降低;假性进展组ASL呈低灌注,Cho/Cr及NAA/Cr比值均降低。对肿瘤真性进展的诊断敏感性,单用ASL为73.0%,单用MRS为71.0%,ASL联合MRS为87.0%。对假性进展诊断敏感性,单用ASL为67.0%,单用MRS为71.0%,ASL联合MRS为85.0%。结论:ASL联合MRS可提高恶性胶质瘤真假性进展诊断的准确性。 Purpose: To explore the application value of a combination of arterial spin labeling(ASL) and magnetic resonance spectroscopy(MRS) for differentiating true progression from pseudo-progression of malignant glioma.Methods: The clinical and imaging data of 22 patients were retrospectively analyzed, including 15 cases of true progression and 7 cases of pseudo-progression, who were admitted from Jan. 2015 to Jul. 2017 in Lanzhou University Second Hospital. The ASL and MRS data of the 22 patients were retrospectively analyzed. The following values were compared between abnormal enhancement area and contralateral normal area: relative cerebral blood flow(rCBF),choline/creatine(Cho/Cr) and N-acetyl aspartate/creatine(NAA/Cr) ratio. Results: In the true tumor progression group, ASL showed high perfusion, MRS showed increased Cho/Cr ratio and decreased NAA/Cr ratio;in the pseudoprogressive group, ASL showed low perfusion, and decreased Cho/Cr and NAA/Cr ratios. The sensitivity of the diagnosis of true tumor progression was 73.0% for ASL alone, 71.0% for MRS alone, and 87.0% for ASL combined with MRS. Sensitivity of the diagnosis of pseudo-progression was 67.0% for ASL alone, 71.0% for MRS alone,and 85.0% for ASL combined with MRS. Conclusion: Combined application of MRS and ASL may improve the diagnostic accuracy to true progression from pseudo-progression of malignant glioma.

作者白玉萍张静欧阳红岳松虹姜艳丽 BAI Yu-ping;ZHANG Jing;OUYANG Hong;YUE Song-hong;JIANG Yan-li

机构地区兰州大学第二医院核磁科

出处《中国医学计算机成像杂志》 CSCD 北大核心 2019年第2期101-105,共5页 Chinese Computed Medical Imaging

基金甘肃省青年科技基金计划No.1606RJY~~

关键词恶性胶质瘤真性进展假性进展动脉自旋标记磁共振波谱 Malignant glioma True progression Pseudo-progression Arterial spin labeling Magnetic resonance imaging

分类号 R445.2 [医药卫生—影像医学与核医学]

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1王季华,张在云,李晓梅,程健,姜玉华.MRS联合ASL在高级别脑胶质瘤假性进展诊断中的应用[J].医学影像学杂志,2016,26(7):1153-1156. 被引量：18
2李万湖,胡旭东,徐亮,杨慧,崔永春,张波,朱玉方,李全太,李洁清.胶质瘤治疗后假性进展的MR波谱分析[J].中国辐射卫生,2014,23(2):112-114. 被引量：6
3葛光治,杨艺,张强.多模态磁共振技术在胶质瘤复发与放射性脑损伤鉴别诊断中的应用价值[J].解放军医学杂志,2015,40(11):921-926. 被引量：30

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