磁共振灌注成像对脑胶质瘤术后复发与放射性损伤的诊断价值

Value of MR perfusion weighted imaging in diagnosis of glioma recurrence and cerebral radiation injuries

关键词:  神经胶质瘤  磁共振成像  放射性脑损伤  灌注成像

Key words:  [Key words]　glioma  magnetic resonance imaging  cerebral radiation injuries  perfusion-weighted imaging

摘要:

目的　通过对脑胶质瘤术后放疗患者的磁共振灌注成像（PWI）研究，探讨其在判断胶质瘤复发与放射性损伤中的价值。　方法　　选取52例脑胶质瘤术后放疗患者，对放疗后影像随访过程中首次出现异常强化病灶的患者进行常规MR及PWI成像，测量病灶强化区域的最大相对脑血容量（rCBVmax）值，根据病理及临床随诊结果，分析PWI对肿瘤复发与放射性损伤的鉴别诊断价值。　结果　　52例患者中，胶质瘤复发30例，放射性损伤22例，常规MR诊断准确率38.5%（20/52），肿瘤复发区rCBVmax值（2.43±1.52），放射性损伤rCBVmax值（0.67±0.44），二者差异具有显著性意义（P=0.000），依据PWI胶质瘤复发与放射性损伤诊断准确率为82.7%（42/52），常规MR与PWI诊断准确率差异具有显著性意义（P<0.001）。 　结论　　磁共振灌注成像能够提高胶质瘤术后复发与放射性损伤诊断的正确率，灌注成像rCBVmax值对胶质瘤复发与放射性损伤鉴别具有重要价值。

Abstract:

[Abstract] Objective　To evaluate the value of Magnetic Resonance perfusion weighted imaging in diagnosis of glioma recurrence and cerebral radiation injuries by the study of the patients with glioma after surgery combined with radiotherapy.　Methods　We selected fifty-two postoperative patients with radiotherapy, and underwent routine MR and PWI to the new abnormal enhancing lesions, we measured the value of rCBVmax, compared analyzing the result of imaging and histology, and evaluated the value of PWI in diagnosis of glioma recurrence and cerebral radiation injuries. 　Results　Thirty cases were glioma recurrence and 22 were cerebral radiation injuries. The rCBVmax were statistically different between recurrent glioma (2.43±1.52) and radionecrosis (0.67±0.44). The diagnostic accuracy were statistically different between routine MR (38.5%, 20/52) and PWI (82.7%, 42/52). 　Conclusion　MR PWI can improve the diagnostic accuracy of glioma recurrence and cerebral radiation injuries, the value of rCBVmax has an important role in the differential diagnosis.