简体中文

·头颈疾病·

磁共振扩散峰度成像MK值、FA值在鉴别高级别胶质瘤与转移 瘤的价值分析

作者:杨海南1 何广明2 吴 辉1 陈志远1 李旭丰1

所属单位:1.广州医科大学附属第四医院放射科 (广东 广州 511447) 2.广州医科大学附属第二医院放射科 (广东 广州 510260)

PDF

摘要

目的 分析磁共振扩散峰度成像(DKI)MK值、FA值在鉴别高级别胶质瘤与转移瘤的价值。方法 选取我院2015年2 月-2015年12月肿瘤科收治的21例高级别胶质瘤和18例转移瘤患者,将其分别记为胶质瘤组和转移瘤组,两组患者 均行常规MRI扫描、DKI序列,选择肿瘤实质区和肿瘤周围水肿区作为感兴趣区(ROI),将所得图像传至工作站进行 软件处理,并分别测量不同区域的平均峰度(MK)值、各向异性(FA)值,运用统计学数据分析软件比较两组ROI检测 值的差异。结果 肿瘤实质区上两组的FA、MK值相较差异均无统计学意义(P>0.05);瘤周水肿区上两组FA值相较差 异无统计学意义(P>0.05),但能较好的显示组织纤维束的破坏程度。胶质瘤组瘤周水肿区MK值(0.512±0.054)较转 移瘤组(0.441±0.048)高,差异具有统计学意义(P<0.05)。结论 DKI序列上FA值能较好的反映肿瘤组织结构及破坏 程度等特征,结合ROI测量的MK值能为鉴别高级别胶质瘤和转移瘤提供重要依据。

Objective To analyze magnetic resonance diffusion kurtosis imaging(DKI) MK and FA values in differentiating highgrade gliomas and metastases. Methods 21 cases of high-grade gliomas and 18 cases of metastases from Feb. 2015 to Dec. 2015 in the fourth affiliated hospital of guangzhou medical university were taken as the clinical research objects, which were divided into gliomas group and metastases group. Both group patients were accepted routine MRI scan and DKI sequence, and their results were transmitted to the workstation. Tumor parenchyma and edema areas were taken as the region of interest (ROI), the average value of kurtosis (MK) and fractional anisotropy ( FA) in different areas were measured respectively. Results There were no significant differences in FA and MK values between the two groups in tumor parenchyma area (P>0.05).There was no significant difference in FA value which could better displayed the damage degree of tissue fiber bundle between the two groups in edema area around tumor (P>0.05). The MK value of the gliomas group was (0.512±0.054 )which was significantly higher than that of the metastases group (0.441±0.048)(P<0.05). Conclusion The FA value of DKI sequence can better reflect the characteristics of tumor tissue structure and the degree of damage, and DKI sequence combined with MK value of ROI can provide an important basis for identification of high-grade gliomas and metastasis.

【关键词】DKI;高级别胶质瘤;单发脑转移瘤;鉴别

【中图分类号】R73-37

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2016.05.001

前言

脑胶质瘤多位于大脑半球,以星形细胞胶质瘤为 主,恶性程度较高具有浸润性生长的特征,临床手术 切除后需结合放化疗治疗,预后较差。转移瘤是身体 其他部位的恶性肿瘤转移至颅内者,这在老年人群体 中较为多见,较大部分患者先出现转移瘤的脑部症状,且在脑转移瘤确诊后仍较难确定原发病灶,预 后较差,临床治疗中根据原发病灶的情况制定综合的 治疗方案。由于脑胶质瘤和转移瘤在早期症状和常规 MRI扫描上均有较多相似之处,且较多脑转移瘤表现 并非典型的“小病灶、大水肿”等因素给早期确诊带