目的 探讨动态增强磁共振成像 与扩散张量成像在胶质瘤分级中的临床价 值。方法 选取我院2016年1月-2017年12 月收治的胶质瘤患者(经病理证实)105例 西门子DCE-MRI检测仪，头颅正交线圈， 行常规MRI轴位、矢状位、冠状位扫描。 梯度场40mT/m，切换率200T/m·s，轴状 位扫描开始单次激发回波平面弥散序列， 扫描参数TR6400ms，FOV230mm×230mm， 于相同编码上重复取样，检测患者头部。 结果 105例患者经组织病理学确诊为胶质 瘤，其中星形细胞瘤47例(Ⅰ级)、Ⅱ级 35例、节细胞胶质瘤Ⅱ10例、室管膜瘤Ⅱ 级3例、间变性星形细胞瘤6例(Ⅲ级)、胶 质母细胞瘤4例(Ⅵ级)。Ⅰ级+Ⅱ级列入低 级别胶质瘤，共有95例。Ⅲ级+Ⅵ级列入 高级别胶质瘤，共有10例。高级别胶质瘤 组患者脑瘤实质区、瘤周水肿区、水肿 旁白质区 DTI值显著低于低级别胶质瘤组 (P<0.05)。低级别胶质瘤组实质部分MD值 显著高于高级别胶质瘤组(P<0.05)，FA值 低于高级别胶质瘤组(P<0.05)。低级别胶 质瘤组对侧半球正常组织MD值高于高级 别胶质瘤组，FA值低于高级别胶质瘤组， 差异比较无统计学意义(P>0.05)。结论 高级别胶质瘤FA值较高，DTI值、MD值较 低，影像学显示为远端纤维束消失，肿瘤 周边纤维束稀疏且部分出现中断形态。

Objective To investigate the clinical value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion tensor imaging (DTI) in glioma grading. Methods A total of 105 cases of pathologically confirmed glioma patients in our hospital from January 2016 to December 2017 were selected, and all siemens received the DCE-MRI and DTI examinations. Results A total of 105 cases of pathologically confirmed glioma patients were consisted of 47 cases of astrocytoma (grade I), 35 cases of astrocytoma (grade II), 10 cases of ganglioneuroma at grade II, 3 cases of ependymoma at grade II, 6 cases of anaplastic astrocytoma (grade III), 4 cases of glioblastoma (grade VI). There were a total of 95 cases low-grade gliomas (I + II) and 10 cases high-grade gliomas (III+VI). The DTI values of brain tumoral parenchyma, peritumoral edema and outer of white matter region edema in high grade glioma group were significantly lower than those in low grade glioma group (P<0.05). The low grade glioma group had higher MD value and lower FA value at parenchyma edema than those of the high grade glioma group (P<0.05), while the low grade glioma group had higher MD value and lower FA value at normal tissues than those of the high grade glioma group, with no statistic difference (P>0.05). Conclusion High-grade gliomas have higher FA values and lower DTI and MD values. The imaging features are characterized as the disappeared distal fiber bundles, sparsely and partially interrupted tumor surrounding fiber bundles.