脑胶质瘤术前3.0T磁共振弥散张量成像分级

目的 探讨3.0T磁共振弥散张量成像(DTI)的表观弥散系数(ADC)和部分各向异性(FA)参数在脑胶质瘤术前分级中的应用价值.方法 回顾性分析104例术后组织病理学证实为脑胶质瘤患者的DTI、ADC和FA参数图,测量瘤实体感兴趣区的ADC和FA值,并与WHO分级进行比较.结果 104例幕上脑胶质瘤患者中:WHO Ⅱ级58例,Ⅲ级25例,Ⅳ级21例.Ⅳ级的ADC值(0.81±0.20)×10~(-3)mm~2/s显著低于Ⅲ级(1.05±0.30)×10~(-3)mm~2/s或Ⅱ级(1.26±0.32)×10~(-3)mm~2/s(P=0.008,P＜0.001),WHO Ⅲ级ADC值显著低于Ⅱ级(P=0.003).WHO Ⅳ级FA值0.18±0.06显著高于Ⅱ级(0.15±0.06)(P=0.046),Ⅳ级与Ⅲ级(0.15±0.10)、Ⅱ级与Ⅲ级间FA值差异无统计学意义.结论 DTI获得的脑胶质瘤实体区ADC和FA的值能在术前区分不同级别的脑胶质瘤,将有助于术前优化脑胶质瘤患者的治疗方案和对预后的判断.

Diffusion tensor imaging for gliomas grading at 3.0T MR: Analysis of apparent diffusion coefficient and fractional anisotropy

Objective To assess the value of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) value at 3.0T diffusion tensor imaging (DTI) in glioma grading before operation. Methods DTI was performed on 104 patients with histologically proved glioma. ADC, FA and DWI maps were produced, and ADC, FA value of solid tumors were measured and compared with the WHO classification of gliomas. Results Fifty-eight gliomas were WHO Ⅱ, 25 were WHO Ⅲ and 21 were WHO Ⅳ. The ADC value of WHO Ⅳ (0.81±0.20)×10~(-3)mm~2/s was lower than that of WHO Ⅲ [(1.05±0.30)×10~(-3)mm~2/s] and WHO Ⅱ[(1.26±0.32)×10~(-3)mm~2/s (P=0.008, P＜0.001)]. The ADC value of WHO Ⅲ was lower than that of WHO Ⅱ (P=0.003). The FA value of WHO Ⅳ (0.18±0.06) was higher than that of WHO Ⅱ (0.15±0.06) (P=0.046). No significance of FA was found between WHO Ⅲ (0.15±0.10) and Ⅱ, nor WHO Ⅳ and Ⅲ. Conclusion ADC and FA value can distinguish different grade gliomas. It is useful in deciding the surgical strategy and predicting the patient's prognosis.