| 孟名柱,周胜利,苗重昌,袁刚.DWI联合1H-MRS多参数分析鉴别胶质瘤术后复发与放射性脑损伤[J].中国医学影像技术,2011,27(5):905~909 |
| DWI联合1H-MRS多参数分析鉴别胶质瘤术后复发与放射性脑损伤 |
| MR DWI combined with 1H-MRS analysis of multi-parameter in distinction of brain glioma recurrence and post-radiation brain injuries |
| 投稿时间：2010-11-16 修订日期：2011-01-16 |
| DOI： |
| 中文关键词: 扩散磁共振成像 胶质瘤 复发 辐射损伤 |
| 英文关键词:Diffusion magnetic resonance imaging Glioma Recurrence Radiation injuries |
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| 中文摘要: |
| 目的 探讨DWI联合1H-MRS鉴别脑胶质瘤术后复发与放射性脑损伤的价值。 方法 对22例脑胶质瘤术后放疗后出现异常强化区的患者进行DWI、1H-MRS检查。分析复发和放射性脑损伤的DWI与1H-MRS表现,对复发、损伤、正常脑白质的ADC值及复发、损伤病灶的Cho、Cr、NAA峰高与Cho/Cr、Cho/NAA值进行统计学分析,并根据ROC曲线确定比值参数(rADC、Cho/Cr、Cho/NAA)的最佳诊断阈值及诊断准确率。 结果 损伤灶ADC值[(1476.40±453.74)mm2/s]高于复发灶[(987.62±309.93)mm2/s],差异有统计学意义(P＜0.05)。复发灶Cho/Cr(1.74±0.53)、Cho/NAA(2.39±1.21)高于损伤灶Cho/Cr(1.30±0.19)、Cho/NAA(1.16±0.41),差异有统计学意义(P均＜0.05)。最佳诊断阈值分别为:rADC(1.40)、Cho/Cr(1.51)和Cho/NAA(1.42),诊断准确率分别为:rADC(72.73%)、Cho/Cr(72.73%)、Cho/NAA(86.36%)、多参数评分系统(86.36%)。 结论 DWI联合1H-MRS多参数分析可明显提高复发与损伤的鉴别诊断准确率,对放射性脑损伤的早期确诊具有重要应用价值。 |
| 英文摘要: |
| Objective To investigate the value of DWI combined 1H-MRS in distinction of brain glioma recurrence and post-radiation brain injuries. Methods Twenty-two postoperative patients with abnormal enhancing lesions underwent DWI and 1H-MRS. Performances of glioma recurrence and post-radiation brain injuries on DWI and 1H-MRS were analyzed, ADC value of contralateral normal white matter and lesions, peaks height of Cho, Cr, NAA and Cho/Cr, Cho/NAA were measured and analyzed statistically. The optimum threshold (OT) and diagnostic accuracy of rADC, Cho/Cr and Cho/NAA were confirmed based on ROC. Results The ADC values of injury lesions ([1476.40±453.74]mm2/s) were significantly higher than those of recurrent lesions ([987.62±309.93]mm2/s, P＜0.05). Cho/Cr (1.74±0.53), Cho/NAA (2.39±1.21) of recurrent lesions were significantly higher than those of injury lesions ([1.30±0.19], [1.16±0.41], respectively (all P＜0.05). OT for rADC, Cho/Cr, Cho/NAA was 1.40, 1.51 and 1.42, respectively. The diagnostic accuracy of rADC, Cho/Cr, Cho/NAA and multi-parametric scoring system was 72.73%, 72.73%, 86.36% and 86.36%, respectively. Conclusion DWI combined with 1H-MRS multi-parameter analysis can improve the accuracy of differential diagnosis between brain glioma recurrence and post-radiation brain injuries, therefore have important application value on the early diagnosis of post-radiation brain injuries. |
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