中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2009年
4期
343-346
,共4页
费小瑞%牛朝诗%王昌新%丁敏%吴晓鸣%丁宛海%傅先明
費小瑞%牛朝詩%王昌新%丁敏%吳曉鳴%丁宛海%傅先明
비소서%우조시%왕창신%정민%오효명%정완해%부선명
神经胶质瘤%磁共振成像,弥散%病理学
神經膠質瘤%磁共振成像,瀰散%病理學
신경효질류%자공진성상,미산%병이학
Glioma%Diffusion magnetic resonance imaging%Pathology
目的 探讨MR DTI在评价胶质瘤病理等级与毗邻纤维束状态之间相关性的价值.方法 选择24例经手术及组织病理学证实的胶质瘤患者,术前行常规MRI、DTI.在各向异性分数(FA)图上,ROI设定在瘤周纤维束FA值最低点(Faa)及对侧半球对称区域(Fac),测量出Faa及Fac值,在相同层面ADC图的相同位置,测量出ADC值最低点(ADCa)及对侧半球对标区域ADC(ADCc)值,计算出相对FA值(rFA)和相对ADC值(rADC).利用纤维束追踪技术重组出肿瘤周围纤维束三维图,根据纤维束三维图对纤维束的状态(推移、浸润或者破坏)进行评价.rFA、rADC及瘤周纤维束的状态与胶质瘤的病理级别之间的关系进行独立样本t检验及趋势X2检验.结果24例胶质瘤患者,其中低级别胶质瘤11例,高级别胶质瘤13例.低级别胶质瘤的rFA值为0.65±0.19,
rADC值为1.43±0.50,重组的痛周纤维束追踪图主要呈被推移或者浸润;高级别胶质瘤的rFA值为1.51±0.39,rADC值为1.70±0.27,重组的瘤周纤维束追踪图主要旱被浸润或者被破坏.rFA值在高级、低级别胶质瘤之间差异有统计学意义(t=8.504,P=0.000),而rADC值差异无统计学意义(t=-1.435,P=0.165);纤维束的状态在高级、低级别胶质瘤之间差异亦有统计学意义(X2=5.882,P=0.015).结论胶质瘤的病理等级影响瘤周纤维束的状态,rFA可作为一个参考指标,有助于鉴别胶质瘤的恶性程度;DTI可清楚显示肿瘤与周围白质纤维的解剖位置关系,并能显示瘤周纤维不的病理状态,指导治疗方案的制定.
目的 探討MR DTI在評價膠質瘤病理等級與毗鄰纖維束狀態之間相關性的價值.方法 選擇24例經手術及組織病理學證實的膠質瘤患者,術前行常規MRI、DTI.在各嚮異性分數(FA)圖上,ROI設定在瘤週纖維束FA值最低點(Faa)及對側半毬對稱區域(Fac),測量齣Faa及Fac值,在相同層麵ADC圖的相同位置,測量齣ADC值最低點(ADCa)及對側半毬對標區域ADC(ADCc)值,計算齣相對FA值(rFA)和相對ADC值(rADC).利用纖維束追蹤技術重組齣腫瘤週圍纖維束三維圖,根據纖維束三維圖對纖維束的狀態(推移、浸潤或者破壞)進行評價.rFA、rADC及瘤週纖維束的狀態與膠質瘤的病理級彆之間的關繫進行獨立樣本t檢驗及趨勢X2檢驗.結果24例膠質瘤患者,其中低級彆膠質瘤11例,高級彆膠質瘤13例.低級彆膠質瘤的rFA值為0.65±0.19,
rADC值為1.43±0.50,重組的痛週纖維束追蹤圖主要呈被推移或者浸潤;高級彆膠質瘤的rFA值為1.51±0.39,rADC值為1.70±0.27,重組的瘤週纖維束追蹤圖主要旱被浸潤或者被破壞.rFA值在高級、低級彆膠質瘤之間差異有統計學意義(t=8.504,P=0.000),而rADC值差異無統計學意義(t=-1.435,P=0.165);纖維束的狀態在高級、低級彆膠質瘤之間差異亦有統計學意義(X2=5.882,P=0.015).結論膠質瘤的病理等級影響瘤週纖維束的狀態,rFA可作為一箇參攷指標,有助于鑒彆膠質瘤的噁性程度;DTI可清楚顯示腫瘤與週圍白質纖維的解剖位置關繫,併能顯示瘤週纖維不的病理狀態,指導治療方案的製定.
목적 탐토MR DTI재평개효질류병리등급여비린섬유속상태지간상관성적개치.방법 선택24례경수술급조직병이학증실적효질류환자,술전행상규MRI、DTI.재각향이성분수(FA)도상,ROI설정재류주섬유속FA치최저점(Faa)급대측반구대칭구역(Fac),측량출Faa급Fac치,재상동층면ADC도적상동위치,측량출ADC치최저점(ADCa)급대측반구대표구역ADC(ADCc)치,계산출상대FA치(rFA)화상대ADC치(rADC).이용섬유속추종기술중조출종류주위섬유속삼유도,근거섬유속삼유도대섬유속적상태(추이、침윤혹자파배)진행평개.rFA、rADC급류주섬유속적상태여효질류적병리급별지간적관계진행독립양본t검험급추세X2검험.결과24례효질류환자,기중저급별효질류11례,고급별효질류13례.저급별효질류적rFA치위0.65±0.19,
rADC치위1.43±0.50,중조적통주섬유속추종도주요정피추이혹자침윤;고급별효질류적rFA치위1.51±0.39,rADC치위1.70±0.27,중조적류주섬유속추종도주요한피침윤혹자피파배.rFA치재고급、저급별효질류지간차이유통계학의의(t=8.504,P=0.000),이rADC치차이무통계학의의(t=-1.435,P=0.165);섬유속적상태재고급、저급별효질류지간차이역유통계학의의(X2=5.882,P=0.015).결론효질류적병리등급영향류주섬유속적상태,rFA가작위일개삼고지표,유조우감별효질류적악성정도;DTI가청초현시종류여주위백질섬유적해부위치관계,병능현시류주섬유불적병리상태,지도치료방안적제정.
Objective To investigate the relationship between the grade of gliomas and the status of adjacent fiber tract with DTL Methods MRI and DTI were performed in 24 patients with histologically confirmed brain gliomas.Regions of interest were placed in the white matter adjacent to the tumor with the lowest FA(Faa) and in the white matter of the contralateral hemisphere(Fac).The values of Faa and Fac were measured.In the regions of the same slice, the values of ADCa and ADCc were measured. Relative fractional anisotropy ratios (rFA) and relative apparent diffusion coefficient ratios (rADC) were also calculated.The status of fiber tracts adjacent to the gliomas were characterized as displacement, infiltration or disruption.Fiber tracking using the Fiber Assignment by Continuous Tracking (FACT) method was performed to investigate the integrity of white matter tracts in the surrounding border zone of the gliomas.The correlation of rFA, rADC, the state of adjacent fiber tracts, and the grade of gliomas were analyzed statistically by using independent sample t test and tendency X2 test.Results Eleven of the 24 tumors were demonstrated as low grade gliomas (WHO grade Ⅰ-Ⅱ) and 13 were high grade giiomas (WHO grade Ⅲ-Ⅳ).The average rFA and rADC of the low grade gliomas were 0.65±0.19 and 1.43 ± 0.50 respectively.Most of fiber tracts in the periphery of the low grade gliomas were displaced or infiltrated.The average rFA and rADC of the high grade gliomas were 1.51 ± 0.39 and 1.70 ±0.27 respectively.Most of fiber tracts in the periphery of the high grade gliomas were infiltrated or disrupted.Significant difference was found for rFA (t =8.504,P =0.000) and but not for rADC(t = - 1.435 ,P =0.165) between low grade and high grade gliomas.Significant difference existed between the state of fiber tracts adjacent to ghomas and low and high-grade(X2 =5.882 ,P =0.015).Conclusions The malignancy of gliomas influences the state of fiber tracts in the vicinity of tumors, rFA can serve as a reference for distinguishment of high-grade and low-grade gliomas.DTI can depict the localization of gliomas and the adjacent fiber tracts.The state of fiber tracts can also be identified by DTI.It is helpful for the therapeutic plan of the tumors.