CAJ | 학술논문

目的：胶质瘤的不同病理类型预示着不同的预后和对治疗的不同反应。通过比较WHOⅡ级胶质瘤不同病理类型肿瘤最大血流量与对侧正常白质血流量比值(nCBF)的差异，回顾性分析三维准连续动脉自旋标记(3D-PCASL)灌注成像在WHO Ⅱ级胶质瘤各种病理类型鉴别诊断中的价值。材料与方法34例经病理证实的WHO Ⅱ级胶质瘤患者术前行常规MR平扫、3D-PCASL、常规增强扫描。运用后处理图像，根据CBF图，术后测量肿瘤区最大CBF值及对侧正常白质区CBF值并求比值(nCBF)，按照病理结果分星形细胞瘤(16例)、少突胶质细胞瘤(13例)和少突星形细胞瘤组(5例)进行nCBF各组间的统计学分析。结果星形细胞瘤平均 nCBF值(1.213±0.506)稍低于少突胶质细胞瘤组(1.283±1.414)，差异没有明显统计学意义(P=0.855)。少突星形细胞瘤由于病例数太少，未纳入统计学分析。结论 WHO Ⅱ级胶质瘤的不同病理类型其灌注值没有明显差异，3D-PCASL在WHO Ⅱ级胶质瘤病理分型中鉴别诊断的临床意义还有待于进一步研究证实。
목적：효질류적불동병리류형예시착불동적예후화대치료적불동반응。통과비교WHOⅡ급효질류불동병리류형종류최대혈류량여대측정상백질혈류량비치(nCBF)적차이，회고성분석삼유준련속동맥자선표기(3D-PCASL)관주성상재WHO Ⅱ급효질류각충병리류형감별진단중적개치。재료여방법34례경병리증실적WHO Ⅱ급효질류환자술전행상규MR평소、3D-PCASL、상규증강소묘。운용후처리도상，근거CBF도，술후측량종류구최대CBF치급대측정상백질구CBF치병구비치(nCBF)，안조병리결과분성형세포류(16례)、소돌효질세포류(13례)화소돌성형세포류조(5례)진행nCBF각조간적통계학분석。결과성형세포류평균 nCBF치(1.213±0.506)초저우소돌효질세포류조(1.283±1.414)，차이몰유명현통계학의의(P=0.855)。소돌성형세포류유우병례수태소，미납입통계학분석。결론 WHO Ⅱ급효질류적불동병리류형기관주치몰유명현차이，3D-PCASL재WHO Ⅱ급효질류병리분형중감별진단적림상의의환유대우진일보연구증실。
Objective:Different subtypes of gliomas present different prognosis and different response to therapy. To retrospectively analyses the differentiating diagnostic accuracy of 3-dimensional pseudocontinous arterial spin labeling (3D-PCASL) in the prediction of WHO grade II gliomas subtyping, and to appraise normalized lesion/normal tissue cerebral blood flow (nCBF) with histological findings as a reference standard. Materials and Methods:34 patients with pathologically proved WHO grade II gliomas underwent conventional magnetic resonance sequences, 3-dimensional pseudocontinuous arterial spin labeling (3D-PCASL) and post-contrast MR imaging. Representative maximal nCBF originated from 3D-PCASL regions of interest were chosen and measured from each lesion. These parameters were used for statistical evaluation according to histopathological result to group astrocytomas (n=16), oligodendrogliomas (n=13) and oligoastrocytomas (n=5). Results:The mean nCBF ratio (1.213±0.506) of astrocytomas was slightly lower than that (1.283±1.414) of oligodendragliomas group. There was no signiifcant difference between both groups for mean nCBF ratio (P=0.854). Without enough sample of oligoastrocytoma group, it was excluded for statistic analysis. Conclusions:There was no obvious difference in perfusion between the different subtypes of WHO grade II gliomas. It should be too early to say that 3D-PCASL is a valuable method for differentiating diagnosis different subtypes of WHO grade II gliomas which will be elucidated in further study.