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CT灌注成像对脑肿瘤瘤周水肿的评价
引用本文:施裕新,徐建峰.CT灌注成像对脑肿瘤瘤周水肿的评价[J].中华放射学杂志,2005,39(5):469-471.
作者姓名:施裕新  徐建峰
作者单位:226001,南通大学附属医院放射科
摘    要:目的 应用CT灌注成像半定量估计脑肿瘤瘤周水肿的灌注状况。方法 应用SomatomPlus4螺旋CT机,对21例脑肿瘤瘤周水肿患者脑膜瘤4例,胶质瘤(Ⅲ~Ⅳ级)7例、转移瘤10例]进行CT灌注成像,经灌注软件处理分别计算瘤周水肿区局部脑血流量(rCBF)、局部脑血容量(rCBV)、对比剂平均通过时间(MTT),并与对侧脑白质和不同肿瘤瘤周水肿间的灌注参数进行比较。结果 脑膜瘤和转移瘤瘤周水肿的rCBF和rCBV明显低于对侧脑白质(rCBF:t=2 .92和3 .82,P值均<0. 05, 0. 005;rCBV:t=2 .42和3. 53, P<0 .05, 0 .01),胶质瘤瘤周水肿的rCBF和rCBV与正常脑白质无明显差别(t=1 .00和1 .33, P值均>0 .05)。瘤周水肿区与对侧正常脑白质rCBF、rCBV比值,脑膜瘤和转移瘤之间差异无统计学意义(t=0 .23和0. 73, P值均>0 .05),胶质瘤明显大于脑膜瘤和转移瘤(t=3 .05和3. 37, P<0 .01, 0 .005)。结论 脑膜瘤和转移瘤瘤周水肿区的rCBF、rCBV显著降低,而胶质瘤瘤周水肿区接近或高于对侧脑白质,CT灌注能定量脑肿瘤瘤周水肿血流灌注状况,有助于肿瘤的鉴别和随访。

关 键 词:CT灌注成像  瘤周水肿  脑肿瘤  Somatom  rCBF  局部脑血流量  平均通过时间  0.05  螺旋CT机  脑膜瘤  转移瘤  脑白质  胶质瘤  水肿区  定量估计  Plus  水肿患者  软件处理  脑血容量  血流灌注  对侧  肿瘤瘤  对比剂  P值  统计学

Peritumoral brain edema in intracranial tumor evaluated by CT perfusion imaging
SHI Yu-xin,XU Jian-feng.Peritumoral brain edema in intracranial tumor evaluated by CT perfusion imaging[J].Chinese Journal of Radiology,2005,39(5):469-471.
Authors:SHI Yu-xin  XU Jian-feng
Abstract:Objective To semi-quantitatively evaluate the cerebral perfusion in the peritumoral brain edema of cerebral tumors using CT perfusion imaging . Methods Twenty-one patients with peritumoral brain edema (including pathologically confirmed meningiomas n=4, metastasis n=10, gliomas n=7) were examined by CT perfusion imaging. The regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), and mean transit time(MTT)were calculated for peritumoral brain edema and the contralateral white matter. The rCBF and rCBV were compared between peritumoral brain edema and the contralateral white matter. The mean ratios (edema/contralateral white matter) of rCBF and rCBV were compared among the three tumors. Results The rCBF and rCBV of peritumoral brain edema were significantly lower than those of contralateral white matter in patients with meningiomas and metastasis (rCBF: t=2.92 and 3.82, P<0.05, 0.005; rCBV: t=2.42 and 3.53, P<0.05, 0.01).The rCBF and rCBV of peritumoral brain edema were not significantly different from those of contralateral white matter in patients with gliomas (t= 1.00 and 1.33, P>0.05). The mean ratios (edema/contralateral white matter) of rCBF and rCBV were not significantly different between meningiomas and metastasis (t=0.23 and 0.73, P>0.05), but both of them were significantly lower than those of gliomas (t=3.05 and 3.37, P<0.01, 0.005). Conclusion The rCBF and rCBV in peritumoral brain edema were significantly lower than those of contralateral white matter in patients with meningiomas and metastasis, while almost the same with or higher than those of contralateral white matter in patients with gliomas. CT perfusion can provide quantitative information of blood flow in peritumoral brain edema, and is useful in the diagnosis and follow-up of cerebral tumors.
Keywords:Tomography  X-ray computed  Brain neoplasms  Brain edema  Regional blood flow
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