轴位弥散和垂直弥散量化分析脑胶质瘤瘤周侵袭性

目的用轴位弥散和垂直弥散量化分析脑胶质瘤瘤周水肿区白质纤维的侵袭性。方法 30例患者进行轴位弥散和垂直弥散磁共振成像,病理证实为脑胶质瘤。30例中16例为低级别脑胶质瘤患者、14例为高级别脑胶质瘤患者,测量、计算和比较患者肿瘤瘤周水肿区和肿瘤对侧正常脑白质的轴位弥散(λ‖)和垂直弥散(λ⊥)。结果低级别脑胶质瘤瘤周水肿的λ‖值(1.31±0.02)、λ⊥值(0.73±0.04)分别与脑胶质瘤对侧正常白质λ‖值(1.29±0.03)、λ⊥值(0.71±0.05)比较,差异均无统计学意义(t分别=1.87、1.73,P均>0.05);高级别脑胶质瘤周水肿的λ‖值(2.21±0.08)、λ⊥值(1.72±0.05)分别与脑胶质瘤对侧正常白质λ‖值(1.29±0.03)、λ⊥值(0.72±0.05)比较,差异均有统计学意义(t分别=56.17、75.12,P均<0.05)。结论低级别脑胶质瘤周边保留大量正常的脑白质,而高级别脑胶质瘤周边大部分脑白质被破坏。脑胶质瘤瘤周水肿区λ‖和λ⊥可作为脑胶质瘤侵袭性的量化指标。

Quantitative analysis of the potential invasive of gliomas by diffusion tensor imaging with axial diffusivity and radial diffusivity

Objective To evaluate peritumoral white matter invasion of gliomas with axial diffusivity and radial diffusivity. Methods Axial diffusivity and radial diffusivity MR imaging was performed in 30 patients with histologically confirmed brain gliomas. Among them, 16 were low-grade gliomas and 14 were high-grade gliomas. Axial diffusivity （λ｜｜）and radial diffusivity （λ⊥ ） were measured, calculated and compared statistically in the peritumoral edema and normal contralateral hemisphere. Results h N （1.31±0.02）andλ⊥ （0.73±0.04） slightly increased in the tumor edema of low-grade gliomas than λ｜｜ （1.29±0.03） and h_L （0.71±0.05） in the normal of the contra-lateral hemisphere, which had no statistic differences （t=1.87,1.73,P〉0.05）; also λ｜｜ （2.21±0.08） and λ⊥ （1.72±0.05） increased in the peritumoral edema of highgrade gliomas than λ｜｜ （1.29±0.03） and h Z （0.72±0.05） in the normal of the contra-lateral hemisphere, which had statistic differences （t=56.17,75.12,P〈0.05）. Conclusions The peritumoral edema of low-grade gliomas contains a considerable amount of preserved white matter. In high-grade gliomas, however, most of these white matter are disarranged. λ｜｜ and λ⊥ of tumor edema can be used to quantize invasive potential of cerebral gliomas.