摘要
目的探讨3.0T磁共振功能成像在胶质瘤术后复发及疗效评估的应用价值。方法回顾性分析在邢台医学院第二附属医院行脑胶质瘤手术的67例患者一般资料,均在手术后化疗1个月以上,以患者二次手术或病理活检结果为诊断脑胶质瘤复发的金标准,并在术后3~6个月,采用计算机断层扫描(CT)、三维动脉自旋标记成像(3D-ASL)、磁共振弥散加权成像(DWI)检测及增强扫描,测量CT检查中脑血容量(CBV)、3D-ASL检查中CBF值及相对CBF(rCBF)、DWI检查的表观扩散系数(ADC)值,采用SPSS 26.0统计软件对文中数据进行分析,依据数据类型,采用t检验或χ^(2)检验进行组间比较。应用受试者工作特征曲线(ROC)分析CBV、3D-ASL、DWI在脑胶质瘤术后复发及疗效评估中的应用价值。结果高级别CBV、rCBF值显著高于低级别胶质瘤患者,ADC值显著低于低级别胶质瘤患者(P<0.05),联合CBV、rCBF、ADC在胶质瘤级别中诊断AUC为0.960,高于单项检查0.790、0.955、0.795(P<0.05);复发组CBV、rCBF值显著高于未复发组,ADC低于未复发组(P<0.05);联合CBV、rCBF、ADC在胶质瘤术后复发中预测AUC为0.965显著高于单项检测0.729、0.929、0.941(P<0.05);治疗有效组CBV、rCBF低于治疗无效组,ADC高于治疗无效组(P<0.05);CBV、3D-ASL、DWI联合在胶质瘤疗效评估中AUC为0.985较单项指标0.842、0.898、0.961更高(P<0.05)。结论CBV、3D-ASL和DWI的联合应用在胶质瘤术后复发及疗效评估中展现了较高的诊断准确性和预测效能,具有重要的临床应用价值。
Objective To investigate the clinical value of 3.0 T functional magnetic resonance imaging in evaluating postoperative recurrence and treatment efficacy of glioma.Methods A retrospective analysis was conducted on the general clinical data of 67 patients who underwent glioma surgery at the Second Affiliated Hospital of Xingtai Medical University.All patients received chemotherapy for more than one month post-surgery.Recurrence of glioma was diagnosed based on secondary surgery or pathological biopsy results as the gold standard.From 3 to 6 months post-surgery,computerized tomography was used to measure cerebral blood volume(CBV),three-dimensional arterial spin labeling was used to measure cerebral blood flow(CBF)and relative CBF(rCBF),and diffusion-weighted imaging with and without contrast enhancement was used to measure apparent diffusion coefficient(ADC).Data were analyzed using SPSS 26.0 statistical software,and the t test orχ^(2) test was used for inter-group comparisons based on data type.The receiver operating characteristic(ROC)curve was applied to evaluate the value of CBV,rCBF,and ADC in assessing postoperative recurrence and treatment efficacy of glioma.Results Patients with high-grade gliomas showed significantly higher CBV and rCBF and significantly lower ADC compared to those with low-grade gliomas(P<0.05).The area under the ROC curve(AUC)of CBV,rCBF,and ADC in combination for grading glioma was 0.960,which was higher than those of individual indicators(0.790,0.955,and 0.795,P<0.05).The recurrence group had significantly higher CBV and rCBF and lower ADC compared to the non-recurrence group(P<0.05).The AUC of CBV,rCBF,and ADC in combination for predicting postoperative glioma recurrence was 0.965,which was significantly higher than those of individual indicators(0.729,0.929,and 0.941,P<0.05).CBV and rCBF were lower and ADC was higher in the effective treatment group than in the ineffective treatment group(P<0.05).The AUC of CBV,rCBF,and ADC in combination for evaluating glioma treatment efficacy was 0.985,which was higher than those of individual indicators(0.842,0.898,and 0.961,P<0.05).Conclusion The CBV,rCBF,and ADC in combination has shown high diagnostic accuracy and predictive efficacy in the evaluation of postoperative recurrence and treatment efficacy of glioma,which has important clinical application value.
作者
施洋
徐翠霞
魏俊明
崔刚
SHI Yang;XU Cuixia;WEI Junming;CUI Gang(The Second Affiliated Hospital of Xingtai Medical College,Xingtai 054000,China)
出处
《中国辐射卫生》
2025年第4期553-558,565,共7页
Chinese Journal of Radiological Health
基金
河北省医学科学研究课题计划资助(20241818)。
关键词
三维动脉自旋标记成像
磁共振弥散加权成像
计算机断层扫描
胶质瘤
术后复发
疗效
Three-dimensional arterial spin labeling imaging
Magnetic resonance diffusion-weighted imaging
Computed tomography
Glioma
Postoperative recurrence
Efficacy
