摘要
目的 :探讨磁共振动态增强(dynamiccontrast -enhancedMRimaging,DMRI)在颅脑肿瘤诊断中的应用价值。材料和方法 :采用FSPGR序列对84例颅脑肿瘤患者行DMRI检查。根据增强后肿瘤实质区信号上升和下降的速度 ,将信号强度 -时间(SI -T)曲线分为3大类型(Ⅰ型为速升型 :90s内到达峰值 ;Ⅱ型为相对快升型 :90～180s内到达峰值 ;Ⅲ型为缓升型 :180s后到达峰值或无峰值)及七个亚型。观察不同肿瘤的SI -T曲线类型 ,分析各肿瘤最大信号强度(SImax)、最大对比增强率(MCER)、到达增强峰值的时间(Tmax)和增强后信号上升速率(Va)的大小变化。结果 :91 %(20/22)的脑膜瘤SI -T曲线为速升(Ⅰ型)或快升型(Ⅱ型) ,其中血管瘤型均为Ⅰ型。垂体瘤75 %(9/12)表现为早期快速强化 ,尤以侵袭性垂体瘤为著。转移瘤均表现为快升型(8例)或速升型(1例)。胶质瘤有65 %(15/23)为缓升型。听神经瘤5例、颅咽管瘤3例、脊索瘤2例、三叉神经鞘瘤1例的动态增强曲线均呈Ⅲ型。脑膜瘤SImax、MCER和Va均明显高于其他各组肿瘤(p<0.001)。血管瘤型脑膜瘤与间变型脑膜瘤间Tmax与Va均有显著差异(p<0.01) ,SImax、MCER无明显差异(p>0.05) ,两者SImax、MCER和Va均明显高于其他亚型(p<0.01)。Ⅲ、Ⅳ级胶质瘤SImax、MCER和Va均明显高于Ⅰ。
To investigate the value of dynamic contrast-enhanced MR imaging(DMRI) in the diagnosis of intracranial tumors.Materials and Method:84 patients with intracranial tumors underwent dynamiccontast MRI with FSPGR sequence.The signal intensity-time(SI-T) curve(three types:Ⅰ-Ⅲ),maximal signal intensity(SImax),time to the maximal signal intensity(Tmax),velocity of intensity ascending(Va) and maximal contrast enhance ratio(MCER) of intracranial tumors were evaluated.Results:91%(20/22) cases of meningiomas,75%(9/12) of pituitary adenomas and 35%(8/23) of gliomas had type Ⅰ or Ⅱ curves.And 15 cases of gliomas,5 of acoustic neuromas,3 of craniopharyngiomas,2 of chordomas and 1 of trigeminal neuroma showed type Ⅲ curves.The values of SImax,MCER and Va of meningiomas were much higher than those of other tumors(p<0.001).The angiomatous meningiomas and malignant meningiomas were significantly different in Tmax and Va(p<0.01) other than in SImax or MCER (p>0.05).Yet the values of SImax,MCER and Va of angiomatous and malignant meningiomas were much higher than those of other ones(p<0.001).Gliomas of grade Ⅲ-Ⅳ were higher than grade Ⅰ-Ⅱ in SImax,MCER and Va(p<0.01).Invasive pituitary adenomas were remarkable in Tmax and Va compared with microadenomas and macroadenomas(p<0.05).Conclusion:Analysis of SI-T curve combining with the parameters of SImax,MCER,Tmax and Va plays an important role in the evaluation of tumor vascularity and differential diagnosis.
出处
《中国医学计算机成像杂志》
CSCD
2001年第6期361-366,共6页
Chinese Computed Medical Imaging
