摘要
目的探讨动态对比增强MRI（DCE—MRI）灌注参数在胶质瘤术后真、假性进展方面的临床应用价值。方法对25例胶质瘤术后同步放化疗患者行头部DCE—MRI检查，该25例患者中被二次手术病理或临床及影像随访证实为胶质瘤术后真性进展（TP）15例，假性进展（PP）10例。采用非参数Mann-Whitney检验，比较胶质瘤TP和PP两组间的DCE—MRI灌注参数[转运常数（Ktrans）、速率常数（Kep）、血管外细胞外间隙体积百分数（Ve）、血浆体积百分数（Vp）]，作ROC曲线分析，明确各项指标在临床上对于胶质瘤真、假性进展诊断的优越性。结果胶质瘤TP组Ktrans、Ve值高于PP组（P〈0．05），Ktrans、Ve值ROC曲线下面积分别为0．990，0．847。Kep值、Vp值在鉴别胶质瘤rrP组与PP组差异无统计学意义（P〉0．05）。结论DCE—MRI可以用于鉴别胶质瘤TP与PP，Ktrans值、Ve值对二者鉴别具有一定的临床意义。
Objective To investigate the clinical application and manifestation of dynamic contrast-enhanced MRI （DCE-MRI） in differentiating true progession from pseudoprogression in patients with glio- bastomas. Methods Twenty five glioma patients were treated with postoperative concurrent chemoradio- therapy and enrolled in this study. All patients were underwent DCE-MRI using a 1.5T scanner. Fifteen patients were confirmed by secondary pathology or clinical and imaging follow-up of patients with gliomas true progession （TP）, 10 patients were pseudoprogress （PP）. Nonparametric Mann-Whitney test was used to compare perfusion parameters between two groups （ TP and PP）, were used for receiver operating characteristic （ROC） curve analysis to clear if these parameters can be the indicators to differentiate true progession from pseudoprogression. Results Ktrans （volume transfer constant ）, Ve （fractional volume of extravascular extracellular） values between TP and PP glioma groups were statistically significant, Ktrans and Ve values were significantly higher in the TP group than in the PP group （P 〈 0. 05）. The areas under the ROC curve are 0. 990 and 0. 847, respectively. Kep （ efflux rate constant） value, Vp （ fractional volume of plasma） value in the identification of glioma TP group and PP group was not statistically significant （P 〉 0. 05 ）. Conclusions DCE-MRI can be used to identify glioma TP and PP, Kt value and Ve value have clinical significance.
出处
《中国医师杂志》
CAS
2017年第8期1152-1155,共4页
Journal of Chinese Physician
基金
湖南省卫生计生委科研基金课题（B2015-107）
关键词
磁共振成像
神经胶质瘤/诊断
诊断
鉴别
Magnetic resonance imaging
Glioma/DI
Diagnosis, differential
