磁共振多模态影像在脑胶质瘤诊断及分级中的应用效果分析

目的探讨多模态脑功能定位在胶质瘤的诊断和分级中的应用价值。方法选择2016年2月至2018年3月在我院就诊的47例脑胶质瘤患者作为研究对象,按照世界卫生组织分级方法分为低级别脑胶质瘤和高级别脑胶质瘤,术前均行常规磁共振成像(MRI)、弥散张量成像(DTI)、磁共振波谱(MRS)、动脉自旋成像(ASL)检查。结果病理分级低级别(Ⅰ~Ⅱ级)和高级别(Ⅲ~Ⅳ级)瘤周水肿具有统计学意义(P<0.05)。高级别胶质瘤灌注明显升高,肿瘤实性部分CBF、患侧/健侧CBF比值均显著高于低级别患者,差异均有统计学意义(P<0.05);低级别和高级别脑胶质瘤患者健侧CBF相比较差异无统计学意义(P>0.05)。高级别和低级别患者Cho/NAA、Cho/Cr、NAA/Cr相比较差异均有统计学意义(P<0.05)。高级别和低级别脑胶质瘤患者ADC、ADC比值、FA、FA比值相比较差异均有统计学意义(P<0.05)。单纯MRS功能成像分析,正确分级胶质瘤的正确率为82.98%(39/47);仅以DTI功能成像分析,正确分级胶质瘤的诊断正确率为68.09%(32/47);仅以ASL功能成像分析,正确分级胶质瘤的诊断正确率为76.60%(36/47);综合3种功能成像分析,正确分级胶质瘤的诊断正确率为97.87%(46/47),显著高于3种功能成像单独应用(χ2=6.021、14.763、9.553,P均<0.05)。结论联合三种磁共振功能成像的多模态脑功能定位可优势互补,提高脑胶质瘤分级准确性,有助于手术方式的确定。

Analysis of the Effect of Magnetic Resonance Multimodal Imaging in the Diagnosis and Grading of Glioma

Objective To study the value of multi-modal brain function in the diagnosis and classification of glioma. Methods 47 cases of brain glioma treated in our hospital from February 2016 to March 2018 were selected as the subject of the study. According to the classification method of the World Health Organization, it was divided into low-grade glioma and high-grade glioma, and the conventional magnetic resonance imaging(MRI), diffusion tensor imaging(DTI), magnetic resonance spectroscopy(MRS), and arterial spin imaging(ASL) were performed before and after the operation. Results The results showed that the grade of pathological grade(stage Ⅰ-Ⅱ) and high-level(Ⅲ-Ⅳ) tumor-week edema were of statistical significance(P<0.05). The ratio of CBF and CBF in high-grade glioma was significantly higher than that in low-grade patients(P<0.05). There was no significant difference between the low-grade and high-grade glioma patients(P>0.05). The difference of Cho/NAA, Cho/Cr and NAA/Cr in high-and low-grade patients was statistically significant(P<0.05). The ADC, ADC ratio, FA, FA ratio of high-level and low-grade glioma patients were statistically significant(P<0.05). The accuracy of the correct classification of glioma was 82.98%(39/47) and 68.09%(32/47). The diagnostic accuracy of the right grade glioma was 76.60%(36/47) only by the imaging and analysis of the function of ASL, and the diagnosis rate of the correct grade glioma was 76.60%(36/47). The diagnostic rate of the right grade glioma was 97.87%(46/47), which was significantly higher than that of three functional imaging(Sup2=6.021, 14.763, 9). 553, (P all<0.05). Conclusion The multi-modal brain function positioning combined with three kinds of magnetic resonance imaging can complement each other, improve the accuracy of the classification of the brain glioma, and contribute to the determination of the operation mode.