CAJ | 학술논문

目的：通过对脑胶质瘤术后放疗患者的磁共振灌注成像（ PWI ）研究，探讨其在判断胶质瘤复发与放射性损伤中的价值。方法选取52例脑胶质瘤术后放疗患者，对放疗后影像随访过程中首次出现异常强化病灶的患者进行常规MR及PWI成像，测量病灶强化区域的最大相对脑血容量（rCBVmax）值，根据病理及临床随诊结果，分析PWI对肿瘤复发与放射性损伤的鉴别诊断价值。结果52例患者中，胶质瘤复发30例，放射性损伤22例，常规MR诊断准确率38．5％（20/52），肿瘤复发区rCBVmax值（2．43±1．52），放射性损伤rCBVmax值（0．67±0．44），二者差异具有显著性意义（P＝0．000），依据PWI胶质瘤复发与放射性损伤诊断准确率为82．7％（42/52），常规MR与PWI诊断准确率差异具有显著性意义（P＜0．001）。结论磁共振灌注成像能够提高胶质瘤术后复发与放射性损伤诊断的正确率，灌注成像rCBVmax值对胶质瘤复发与放射性损伤鉴别具有重要价值。
목적：통과대뇌효질류술후방료환자적자공진관주성상（ PWI ）연구，탐토기재판단효질류복발여방사성손상중적개치。방법선취52례뇌효질류술후방료환자，대방료후영상수방과정중수차출현이상강화병조적환자진행상규MR급PWI성상，측량병조강화구역적최대상대뇌혈용량（rCBVmax）치，근거병리급림상수진결과，분석PWI대종류복발여방사성손상적감별진단개치。결과52례환자중，효질류복발30례，방사성손상22례，상규MR진단준학솔38．5％（20/52），종류복발구rCBVmax치（2．43±1．52），방사성손상rCBVmax치（0．67±0．44），이자차이구유현저성의의（P＝0．000），의거PWI효질류복발여방사성손상진단준학솔위82．7％（42/52），상규MR여PWI진단준학솔차이구유현저성의의（P＜0．001）。결론자공진관주성상능구제고효질류술후복발여방사성손상진단적정학솔，관주성상rCBVmax치대효질류복발여방사성손상감별구유중요개치。
Objective To evaluate the value of Magnetic Resonance perfusion weighted imaging in diagnosis of glioma re -currence and cerebral radiation injuries by the study of the patients with glioma after surgery combined with radiotherapy . Methods We selected fifty-two postoperative patients with radiotherapy , and underwent routine MR and PWI to the new abnormal enhancing lesions , we measured the value of rCBVmax , compared analyzing the result of imaging and histology , and evaluated the value of PWI in diagnosis of glioma recurrence and cerebral radiation injuries .Results Thirty cases were glioma recurrence and 22 were cerebral radiation injuries .The rCBVmax were statistically different between recurrent glio-ma (2.43 ±1.52) and radionecrosis (0.67 ±0.44).The diagnostic accuracy were statistically different between routine MR (38.5%, 20/52) and PWI (82.7%, 42/52).Conclusion MR PWI can improve the diagnostic accuracy of glioma recurrence and cerebral radiation injuries , the value of rCBVmax has an important role in the differential diagnosis .