原发性脑淋巴瘤与高级别脑胶质瘤的MR灌注成像对照研究

目的 评价MR灌注成像鉴别诊断原发性脑淋巴瘤和高级别脑胶质瘤的价值.资料与方法 对经手术病理或定向穿刺活检证实的11例原发性脑淋巴瘤行MRI常规平扫、MR灌注成像和增强扫描.另随机搜集经手术病理证实的25例胶质母细胞瘤患者资料,用于MR灌注成像对比研究.MR灌注成像采用动态磁敏感性对比增强技术,计算每例肿瘤最大相对脑血容量(rCBV)比值和相对平均通过时间(rMTT)比值,用两样本t检验,比较分析原发性脑淋巴瘤和胶质母细胞瘤的平均最大rCBV比值和平均rMTT比值.结果 增强后11例脑淋巴瘤均有强化,其中7例重度强化、3例中重度强化、1例中度强化;25例脑胶质母细胞瘤的实质部分多呈不均匀性中重度强化,肿瘤内有不同程度的坏死和囊变.11例原发性脑淋巴瘤的平均最大rCBV比值为2.05、平均rMTT比值为1.07;25例胶质母细胞瘤的平均最大rCBV比值为6.78、平均rMTT比值为1.04.两者之间平均最大rCBV比值差异有统计学意义(t=8.15,P＜0.01)、平均rMTT比值差异无统计学意义(t=0.96,P＞0.05).结论 原发性脑淋巴瘤具有低rCBV比值的趋势,结合其常规MRI表现,MR灌注成像可作为鉴别原发性脑淋巴瘤与高级别脑胶质瘤的一种有效的方法 .

Comparative Study of Perfusion MR Imaging in Primary Cerebral Lymphomas and High Grade Gliomas

Objective To evaluate the value of perfusion MR imaging in the differential diagnosis of primary cerebral lymphomas and high grade gliomas.Materials and Methods 11 patients with primary cerebral lymphomas were verified by surgical resection or stereotactic biopsy.All patients underwent conventional MRI,perfusion MR imaging and enhanced MRI examination.25 patients with surgically and pathologically verified glioblastoma multiformes were taken for comparison by perfusion MR imaging.Perfusion MR imaging was pe...