CAJ | 학술논문

目的：探讨联合磁共振扩散张量成像(diffusion tensor imaging，DTI)和波谱分析(magnetic resonance spectroscopy，MRS)对胶质母细胞瘤放疗前后的评价价值。材料与方法选取8例经病理证实为胶质母细胞瘤的术后复发患者，在放疗前、后均行常规MRI平扫、增强、DTI及MRS序列扫描，测量肿瘤实质区、瘤周水肿区的各向异性分数值(fractional anisotropy，FA)、平均表观扩散值(apparent diffusion coefficient，ADC)及代谢物比值包括NAA/Cr、Cho/Cr、Lip/Cr，所得数据采用配对样本t检验进行统计学分析。结果放疗后肿瘤实质区ADC值较放疗前升高(t=3.320，P=0.013)，放疗后肿瘤实质区Cho/Cr较放疗前降低(t=2.960， P=0.021)，放疗后瘤周水肿区Cho/Cr较放疗前降低(t=2.867，P=0.024)。结论联合应用DTI和MRS检查能够反应胶质母细胞瘤放疗后的变化，可用于监测和评价放疗效果。
목적：탐토연합자공진확산장량성상(diffusion tensor imaging，DTI)화파보분석(magnetic resonance spectroscopy，MRS)대효질모세포류방료전후적평개개치。재료여방법선취8례경병리증실위효질모세포류적술후복발환자，재방료전、후균행상규MRI평소、증강、DTI급MRS서렬소묘，측량종류실질구、류주수종구적각향이성분수치(fractional anisotropy，FA)、평균표관확산치(apparent diffusion coefficient，ADC)급대사물비치포괄NAA/Cr、Cho/Cr、Lip/Cr，소득수거채용배대양본t검험진행통계학분석。결과방료후종류실질구ADC치교방료전승고(t=3.320，P=0.013)，방료후종류실질구Cho/Cr교방료전강저(t=2.960， P=0.021)，방료후류주수종구Cho/Cr교방료전강저(t=2.867，P=0.024)。결론연합응용DTI화MRS검사능구반응효질모세포류방료후적변화，가용우감측화평개방료효과。
Objective: To discuss the value of diffusion tensor imaging (DTI) in combination with magnetic resonance spectroscopy (MRS) in glioblastoma before and after radiotherapy. Materials and Methods: 8 patients with recurrent glioblastoma conifrmed by pathological method were selected to receive conventional MRI, contrast-enhanced scanning, DTI and MRS sequence scan before and after radiotherapy. The fractional anisotropy (FA) value, apparent diffusion coefifcient (ADC) value metabolite ratios including NAA/Cr, Cho/Cr, Lip/Cr were measured according to different regions including tumor parenchyma, peritumoral edema. All the data were analyzed by paired-samples t test. Results: The ADC value of tumor parenchyma after radiotherapy increased compared to that before radiotherapy (t=3.320, P=0.013). Cho/Cr of tumor parenchyma after radiotherapy decreased compared to that before radiotherapy (t=2.960, P=0.021). Cho/Cr of peritumoral edema after radiotherapy decreased compared to that before radiotherapy (t=2.867, P=0.024). Conclusions:Combined application of DTI and MRS contribute to relfect changes post radiotherapy and can be used to monitor and evaluate the effect of radiotherapy.