CAJ | 학술논문

目的评价磁共振灌注加权成像(PWMRI)对脑胶质瘤术后放疗后复发的鉴别价值.方法对35例脑胶质瘤术后放疗后疑似肿瘤复发者(真复发20例、假复发15例)同时行MRI和PWMRI检查.在局部脑血容量(rCBV)图上对应病变强化区、近侧水肿区及对侧半球正常脑白质区选择感兴趣区测量rCBV值,计算标准化rCBV比值,记录每一病变区最大rCBV( rCBVmax)比值.比较二者间平均rCBVmax比值差异并行成组t检验,对病变强化区rCBVmax比值行受试者工作特征(ROC)曲线分析.结果肿瘤复发组病变强化区平均rCBVmax比值显著高于非肿瘤复发组(4.36∶1.28,t=3.00,P=0.005),肿瘤复发组周围水肿区平均rCBVmax比值也高于非肿瘤复发组(1.79∶0.85,t =2.41,P =0.026).ROC曲线分析将病变强化区rCBVmax比值＞2.15判断为肿瘤复发时4例肿瘤复发和3例非肿瘤复发被错误分类,PWMRI对肿瘤复发诊断敏感性、特异性和准确性均为80％.结论 PWMRI对胶质瘤术后放疗后复发有很大鉴别价值.
목적 평개자공진관주가권성상(PWMRI)대뇌효질류술후방료후복발적감별개치.방법 대35례뇌효질류술후방료후의사종류복발자(진복발20례、가복발15례)동시행MRI화PWMRI검사.재국부뇌혈용량(rCBV)도상대응병변강화구、근측수종구급대측반구정상뇌백질구선택감흥취구측량rCBV치,계산표준화rCBV비치,기록매일병변구최대rCBV( rCBVmax)비치.비교이자간평균rCBVmax비치차이병행성조t검험,대병변강화구rCBVmax비치행수시자공작특정(ROC)곡선분석.결과 종류복발조병변강화구평균rCBVmax비치현저고우비종류복발조(4.36∶1.28,t=3.00,P=0.005),종류복발조주위수종구평균rCBVmax비치야고우비종류복발조(1.79∶0.85,t =2.41,P =0.026).ROC곡선분석장병변강화구rCBVmax비치＞2.15판단위종류복발시4례종류복발화3례비종류복발피착오분류,PWMRI대종류복발진단민감성、특이성화준학성균위80％.결론 PWMRI대효질류술후방료후복발유흔대감별개치.
Objective To evaluate the role of perfusion weighted magnetic resonance imaging ( PWMRI ) in distinguishing brain glioma recurrence for postoperative radiotherapy patients.Methods Thirty-five patients with suggested recurrent brain glioma (20 true,15 false) were examined by conventional MRI and PWMRI.Regions of interests (ROI) were manually drawn in contrast-enhancing lesion,surround edema region and normal white matter of contra-lateral brain on regional cerebral blood volume (rCBV) images.rCBV values of ROI and rCBVmax were measured,the standardized rCBV ratios were calculated,The mean rCBVmax ratio were compared between two lesion types with group t-test.The rCBVmax ratios of contrastenhancing regions was analyzed by the receiver operating characteristic curve.Results The mean rCBVmax ratio of contrast-enhancing lesion in tumor recurrence was higher than those in non tumor recurrence (4.36vs 1.28,t =3.00,P =0.005 ).The mean rCBVmax of edema regions in tumor recurrence was also higher than those in non tumor recurrence ( 1.79 vs 0.85,t =2.41,P =0.026).Four patients with recurrent tumor and three with non tumor recurrence were wrong diagnosed when set the recurrent tumor rCBVmax ratio ＞2.15.The diagnostic sensitivity,specificity and accuracy for recurrent tumor by PWMRI were 80％respectively.Conclusion PWMRI examination is a useful method for distinguishing brain glioma recurrence.