目的观察并分析灌注成像与CT 增强扫描对脑胶质瘤术前分级的判断准 确性。方法 对2009年1月至2012年12月 来我院就诊并治疗的76例脑胶质瘤患者 作回顾性分析，进行灌注扫描与CT增强 扫描，以两种诊断方法的影像学资料为 基础，灌注成像参考脑血容量(CBV)、脑 血流量(CBF)和脑血管表面通透性(PS)和 相对脑血容量(rCBV)值进行术前分级， CT增强扫描以影像学图片为判断依据， 对比术后病理结果，比较两组术前分级 准确率。结果 以术后病理结果为标准， 灌注成像中，两级别组病灶区域的CBF、 PS、CBV、rCBV值均大于对侧正常区域的 对应值(P＜0.05)，高级别组各灌注参数 显著大于低级别组对应值(P＜0.05)。 灌注成像在低级别组、高级别组的判断 准确率分别为90.24%、91.43%，均显 著高于CT增强扫描的准确率73.17%、 71.43%(P＜0.05)。结论 灌注成像对脑 胶质瘤术前分级准确性均高于CT增强扫 描，是一种有效的胶质瘤术前诊断技 术。

Objective To observe and analyze the accuracy of perfusion imaging and CT scan in determining preoperative grading of gliomas. Methods 76 cases of patients with gliomas who were treated in our hospital between January 2009 and December 2012 were retrospectively analyzed. All underwent perfusion scan and CT enhanced scan. Based on the imaging data of the two kinds of diagnostic methods, preoperative grading of perfusion imaging was performed with reference to cerebral blood volume (CBV), cerebral blood flow (CBF), cerebrovascular permeability surface (PS) and relative cerebral blood volume (rCBV) values. Results The postoperative pathological results were taken as the standard. In terms of perfusion imaging, the values of CBF, PS, CBV and rCBV of lesion areas in the two different grade of groups were greater than the corresponding values of the contralateral normal areas (P＜0.05). The perfusion parameters of high grade group were significantly greater than the corresponding values of low grade group (P ＜0.05). The determination accuracy rates of perfusion imaging in low and high grade group (90.24%,91.43%) were significantly higher than those of CT enhanced scan (73.17%, 71.43%) (P＜0.05). Conclusion The accuracy rate of perfusion imaging in determining preoperative grading of gliomas is higher than that of CT enhanced scan. It is an effective method for preoperative diagnosis of gliomas