摘要
目的探讨颅脑磁共振增强、脑灌注成像（PWI）扫描应用于高级别脑胶质瘤术后复发与放射性脑损伤的鉴别诊断。方法回顾性分析医院2012年6月至2016年3月经手术或回访证实的76例高级别脑胶质瘤术后辅助放疗后患者的MRI平扫、增强及PWI扫描的影像学资料，所有病灶均强化，测量强化区与正常区的参数比值，即相对脑血容量（rCBV）、相对脑血流量（rCBF）的比值，分析放射性脑损伤与术后肿瘤复发的影像学表现区别。结果58例为术后复发，18例为放射性脑损伤。脑放射学损伤组rCBV及rCBF比值的M值分别为0．52（范围0．24-1．10）、0．516（范围为0．20～1．02），低于脑胶质瘤复发组，复发组的rCBV及rCBF比值的M值分别为2．12（范围为1．03～4．72）、1．896（范围为0．80～4．56）。结论PWI对胶质瘤复发和放射性脑损伤有很好的鉴别价值。MRI增强扫描也有一定的鉴别能力。
Objective To investigate the differential diagnosis of cerebral MRI enhancement and cerebral perfusion imaging （PWI） scanning between postoperative recurrence and radiation brain injury of high-level glioma. Methods The imaging data of postoperative MRI scan, enhanced and PWI scanning of 76 patients with high-level glioma after radiotherapy, confirmed by surgery or return visit from Jun. 2012 to Mar. 2016 in hospital, were analyzed retrospectively, and all lesions were enhanced. To measure the ratio parameters between the reinforcement region and the normal area, such as the relative cerebral blood volume （rCBV） and relative cerebral blood flow （rCBF） ratio, and analyzed the difference of ima- ging manifestations between radiation brain injury and postoperative tumor recurrence. Results Fifty- eight cases had postoperative recurrence and 18 cases had radiation brain injury. The M values of rCBV and rCBF ratios of brain radiation injury group were 0.52 （ranged from 0.24 to 1.10）, 0. 516 （ranged from 0.2 to 1.02） , which were significantly lower than glioma recurrence group. The rCBV and rCBF ratio of glioma recurrence group were 2. 12 （ ranged from 1.03 to 4.72 ） , 1. 896 （ ranged from 0. 8 to 4.56）. Conclusions PWI has good identification value for glioma recurrence and radiation brain injury, and MRI enhancement scanning also has the ability to identify.
出处
《中国实用医刊》
2018年第16期27-29,共3页
Chinese Journal of Practical Medicine
关键词
脑胶质瘤
放射治疗
胶质瘤复发
脑损伤
磁共振成像
Glioma
Radiotherapy
Recurrent glioma
Brain injury
Magnetic resonance imaging
