DCE-MRI在高、低级别脑胶质瘤及脑膜瘤中的鉴别诊断

目的通过对高、低级别脑胶质瘤和脑膜瘤患者术前行T1动态增强磁共振成像(dynamic contrast-enhanced MRI,DCE-MRI)检查,为上述3种肿瘤的鉴别诊断提供定量依据。材料与方法收集经手术病理证实的脑胶质瘤(低级别胶质瘤7例,高级别胶质瘤12例)和脑膜瘤(良性脑膜瘤13例、间变或恶性脑膜瘤6例)患者各19例,所有患者术前均行DCE-MRI检查。利用血流动力学双室模型Extended Tofts Linear对各组数据进行微血管渗透性定量分析,获取病变实性成分的T1加权信号时间浓度曲线及血流动力学参数血液渗漏到血管外细胞外间隙速率(转运系数)Ktrans、对比剂血管外细胞外液间隙容积Ve、对比剂血浆容积(血管空间容积分数)Vp],经统计学分析,比较各参数在这3种肿瘤中是否存在统计学差异。结果高级别胶质瘤Ktrans值、Ve值均高于低级别胶质瘤,二者均有统计学差异(P0.05);高级别胶质瘤Vp值略高于低级别胶质瘤,但无统计学差异;脑膜瘤Ktrans、Ve值均显著高于低级别胶质瘤,二者差异有统计学意义(P0.05),脑膜瘤Vp值略高于低级别胶质瘤,但无统计学差异;高级别胶质瘤和脑膜瘤的Ktrans值、Ve值、Vp值差异均无统计学意义(P0.05)。结论 DCE-MRI能有效将低级别与高级别胶质瘤、低级别胶质瘤与脑膜瘤定量区分开来,同时,通过DCE-MRI定量分析提高了脑胶质瘤和侵袭性脑膜瘤诊断的准确率。

Dynamic contrast-enhanced MRI in the differential diagnosis of high grade glioma,low grade glioma and meningioma

AbstractObjective:Through undergoing dynamic contrast-enhanced MRI (dynamic contrast-enhanced MRI, DCE-MRI) before operation to provide quantitative basis for the differential diagnosis of the three kinds of tumors.Materials and Methods:Nineteen cases of gliomas (7 with low grade, 12 with high grade) and 19 cases of meningiomas (13 with benign, 6 with malignant or anaplastic) were enrolled. The pharmacokinetic model of Extended Tofts Linear was used to calculate the datas, the tissue enhancement-time curve and pharmacokinetic parameters (volume transfer constant, Ktrans, extracellular extravascular volume fraction, Ve; and blood plasma fraction, Vp) of the lesion, solid components were obtained. Ktrans value, Ve value and Vp value were compared to judge whether there were signiifcant differences between the three kinds of tumors.Results:The values of Ktrans and Ve in high grade glioma (HGG) were signiifcantly higher than the low grade glioma(LGG) (P<0.05); Vp values of high grade glioma were slightly higher than the low grade glioma, but the difference was not statistically signiifcant; The values of Ktrans and Ve in meningiomas were signiifcantly higher than the low grade gliomas (P<0.05), but the difference of Vp values were not statistically significant; the differences of Ktrans, Ve, Vp of gliomas and meningiomas were not statistically significant (P>0.05).Conclusion:DCE-MRI can effectively distinguish low grade glioma from high grade glioma and low grade glioma from meningioma, At the same time, DCE-MRI improves the diagnosis accuracy of glioma and invasive meningioma through the quantitative analysis .