摘要
目的评估磁共振扩散张量成像(DTI)在Ⅱ、Ⅲ级胶质瘤的鉴别诊断中的应用价值;评价扩散张量纤维束成像(DTT)在显示胶质瘤与周围脑白质纤维束关系中的应用价值。方法搜集经神经外科手术病理证实的Ⅱ、Ⅲ级胶质瘤患者共22例(WHO分级Ⅱ级胶质瘤10例,Ⅲ级胶质瘤12例)。所有病例术前均行常规MRI扫描(T1WI、T2WI、三平面T1WI增强)及扩散张量成像。通过测量肿瘤实质区的FAmean值、rFAmean值、FAmax值、FAmin值、ADCmean值、rADCmean值、ADCmin值,采用独立样本t检验,分析各测量值是否存在差异并判断对肿瘤鉴别诊断是否有价值。利用DTI后处理工作站的纤维束追踪功能对病变周围脑白质纤维束进行重建,观察肿瘤与脑白质纤维束之间的关系。结果Ⅱ级胶质瘤肿瘤实质区的FAmax值(0.349±0.095)、FAmean值(0.202±0.029)、rFAmean值(0.293±0.047)均小于Ⅲ级胶质瘤的FAmax值(0.432±0.085)、FAmean值(0.241±0.017)、rFAmean值(0.357±0.034),差异具有统计学意义(P<0.05),Ⅱ级胶质瘤肿瘤实质区的ADCmin值(0.792±0.082)大于Ⅲ级胶质瘤的ADCmin值(0.709±0.058),差异具有统计学意义(P<0.05)。Ⅱ级胶质瘤周围的白质纤维束多呈移位、水肿改变,而Ⅲ级胶质瘤周围的白质纤维束多表现为以浸润、中断破坏为主。结论DTT纤维束示踪技术能较直观的显示肿瘤与邻近纤维束的关系,结合FA、ADC相关指标,有助于鉴别Ⅱ、Ⅲ级胶质瘤。
Objective To evaluate the application value of magnetic resonance diffusion tensor imaging(DTI)in the differential diagnosis of gradeⅡandⅢglioma;to evaluate diffusion tensor tractography(DTT)in showing the relationship between glioma and peripheral white matter fiber tracts Application value.Methods A total of 22 patients with gradeⅡandⅢglioma confirmed by neurosurgery and pathology were collected(10 cases of WHO gradeⅡglioma and 12 cases of gradeⅢglioma).Routine MRI scans(T1WI,T2WI,and three-plane T1WI enhancement)and diffusion tensor imaging was performed before operation in all cases.By measuring the FAmean value,rFAmean value,FAmax value,FAmin value,ADCmean value,rADCmean value,ADCmin value of the tumor parenchymal area,independent sample t test was used to analyze whether the measured values were different and evaluate whether they are valuable for tumor differential diagnosis.We used the fiber tractography of the DTI post-processing workstation to reconstruct the white matter fiber bundles around the lesion,and observe the relationship between the tumor and the white matter fiber bundles.Results The FAmax value(0.349±0.095),FAmean value(0.202±0.029),and rFAmean value(0.293±0.047)of the tumor parenchymal area of gradeⅡglioma were all lower than the FAmax value(0.432±0.085)and FAmean of gradeⅢglioma Value(0.241±0.017),rFAmean value(0.357±0.034)and the difference was statistically significant(P<0.05).The ADCmin value(0.792±0.082)of the tumor parenchymal area of gradeⅡglioma was greater than that of gradeⅢglioma Value(0.709±0.058)and the difference was statistically significant(P<0.05).The white matter fiber bundles around gradeⅡgliomas are mostly displaced and had edema,while the white matter fiber bundles around gradeⅢgliomas are mostly characterized by infiltration,interruption and destruction.Conclusion DTI tractography can display the relationship between tumor and adjacent fiber bundles more intuitively,when combined with FA and ADC related indicators,it is helpful in distinguishing gradeⅡandⅢgliomas.
作者
曾盛熊
王成伟
彭少华
ZENG Shengxiong;WANG Chengwei;PENG Shaohua(CT/MRI Room,the First Affiliated Hospital of Xinjiang Shihezi University Medical College,Shihezi,Xinjiang Uygur Autonomous Region 832000,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第7期1253-1257,共5页
Journal of Clinical Radiology
关键词
胶质瘤
扩散张量成像
扩散张量纤维束成像
Glioma
Diffusion tensor imaging
Diffusion tensor fiber bundle imaging
