摘要
目的:探讨三维动脉自旋标记(three-dimensional arterial spin labeling,3D-ASL)与动态磁敏感对比增强(dynamic susceptibility contrast-enhanced,DSC)-灌注加权成像(perfusion-weighted imaging,PWI)在鉴别高级别脑胶质瘤(high-grade glioma,HGG)术后复发和放射性脑坏死鉴别诊断中的价值。方法:回顾并分析40例HGG术后辅助放射治疗并在磁共振成像(magnetic resonance imaging,MRI)随访中出现术区新增异常强化灶的患者,经过二次手术病理学检查或长期随访确诊术后复发20例,放射性脑坏死20例。所有患者均行常规MRI、3D-ASL扫描,32例行DSC-PWI扫描,得到病灶实性及对侧镜像正常部位相关的血流动力学参数值,分析各灌注参数在HGG术后复发和放射性脑坏死鉴别诊断中的价值。结果:HGG术后复发组的血流动力学参数3D-ASL-平均相对脑血流量(3D-ASL-relative cerebral blood flow,ASLrCBF)、DSC-PWI-rCBF(DSC-rCBF)、DSC-平均相对脑血容量(DSC-relative cerebral blood volume,DSC-rCBV)明显高于放射性脑坏死组(P<0.01),且ASL-rCBF的诊断效能最高,以ASL-rCBF=2.32为临界值,诊断效能最高;而DSC-平均相对通过时间(DSC-relative mean transit time,DSC-rMTT)及DSC-平均相对达峰时间(DSC-relative time to peak,DSCrTTP)在HGG术后复发组和放射性脑坏死组之间的差异无统计学意义(P=0.21、0.15)。结论:3D-ASL、DSC-PWI均可鉴别HGG术后复发和放射性脑坏死,并且ASL-rCBF诊断效能略高于DSC-rCBF、DSC-rCBV。
Objective:To explore the value of three-dimensional arterial spin labeling(3D-ASL)and dynamic susceptibility contrast-enhanced(DSC)-perfusion-weighted imaging(PWI)in the differential diagnosis of postoperative recurrence and radiation necrosis of high-grade glioma(HGG).Methods:40 patients with HGG who underwent postoperative magnetic resonance imaging(MRI)follow-up with abnormal enhanced lesions were selected.20 cases of postoperative recurrence and 20 cases of radiation necrosis were confirmed by the second operation pathology or long-term follow-up examination.All cases underwent routine MRI,MRI enhancement,3D-ASL,32 cases underwent DSC-PWI.The values of hemodynamic parameters related to focal reactivity and normal contralateral image were got,and the values of perfusion parameters in the differential diagnosis of postoperative recurrence and radiation necrosis of HGG were analyzed statistically.Results:The hemodynamic parameters of 3D-ASL-relative cerebral blood flow(ASL-rCBF),DSC-PWI-rCBF(DSC-rCBF)and DSC-relative cerebral blood volume(DSC-rCBV)in the postoperative recurrence group of HGG were significantly higher than those in the radiation necrosis group(P<0.01).ASL-rCBF has the highest diagnostic efficiency.And when ASL-rCBF=2.32 is the critical value,the diagnostic efficiency is the highest.While,there were no statistically significant differences in DSC-relative mean transit time(DSC-rMTT)and DSC-relative time to peak(DSC-rTTP)between the postoperative recurrence and the radiation necrosis(P=0.21,0.15).Conclusion:Both 3D-ASL and DSC-PWI can distinguish postoperative recurrence and radiation necrosis of HGG,and the diagnostic efficacy of ASL-rCBF was slightly higher than that of DSC-rCBF and DSC-rCBV.
作者
石慧娴
韩雷
叶靖
张洪英
SHI Huixian;HAN Lei;YE Jing;ZHANG Hongying(Graduate School,Dalian Medical University,Dalian 116044,Liaoning Province,China;Department of Radiology,Subei People’s Hospital,Yangzhou 225001,Jiangsu Province,China)
出处
《肿瘤影像学》
2020年第3期324-329,共6页
Oncoradiology
基金
国家自然科学基金面上项目(81471642)。
关键词
高级别脑胶质瘤
复发
放射性脑坏死
磁共振成像
灌注加权成像
High-grade glioma
Recurrence
Radiation necrosis
Magnetic resonance imaging
Perfusion-weighted imaging
