CAJ | 학술논문

目的：探讨容积转运常数(volume transfer constant,Ktrans )对高级别胶质瘤(high grade glioma,HGG)与脑转移瘤的鉴别诊断价值。方法收集经手术病理证实的 HGG 12例及脑转移瘤27例,所有患者均行 MR动态增强检查(dynamic contrast en-hance MRI,DCE-MRI),对比剂为钆喷酸葡胺,剂量0.1 mmol/kg体重,注射速度3 mL/s。采用盲法读片,测量颅内占位性病变实质区及瘤周水肿区的Ktrans值。使用 SPSS13.0进行统计学分析,对脑转移瘤与 HGG之间 Ktrans差异的比较采用Mann-Whitney U检验,P<0.05认为差异有统计学意义。进一步利用受试者工作特征(receiver operation characteristic,ROC)曲线进行分析,找出最佳阈值,并分别计算灵敏度、特异度。结果脑转移瘤与HGG肿瘤实质区的Ktrans及Ve值差异均无统计学意义(P>0.05),而瘤周水肿区Ktrans值的差异具有统计学意义(P<0.05)。Ktrans以0.03 min-1为阈值时,鉴别诊断脑转移瘤与 HGG的灵敏度75%,特异度70%。结论根据瘤周水肿区域的Ktrans值,可对脑转移瘤与高级别胶质瘤的鉴别提供帮助。
목적：탐토용적전운상수(volume transfer constant,Ktrans )대고급별효질류(high grade glioma,HGG)여뇌전이류적감별진단개치。방법수집경수술병리증실적 HGG 12례급뇌전이류27례,소유환자균행 MR동태증강검사(dynamic contrast en-hance MRI,DCE-MRI),대비제위구분산포알,제량0.1 mmol/kg체중,주사속도3 mL/s。채용맹법독편,측량로내점위성병변실질구급류주수종구적Ktrans치。사용 SPSS13.0진행통계학분석,대뇌전이류여 HGG지간 Ktrans차이적비교채용Mann-Whitney U검험,P<0.05인위차이유통계학의의。진일보이용수시자공작특정(receiver operation characteristic,ROC)곡선진행분석,조출최가역치,병분별계산령민도、특이도。결과뇌전이류여HGG종류실질구적Ktrans급Ve치차이균무통계학의의(P>0.05),이류주수종구Ktrans치적차이구유통계학의의(P<0.05)。Ktrans이0.03 min-1위역치시,감별진단뇌전이류여 HGG적령민도75%,특이도70%。결론근거류주수종구역적Ktrans치,가대뇌전이류여고급별효질류적감별제공방조。
Objective To determine whether volume transfer coefficient (Ktrans )can be used to differentiate high-grade glioma (HGG)and metastasis.Methods Thirty-nine patients with brain tumors (12 HGG,27 metastases)underwent dynamic contrast en-hanced MR imaging before surgical resection or stereotactic biopsy.Images were acquired with a three-dimensional (3D)fast gradi-ent echo sequence.Gadolinium-based contrast agent was injected intravenously with dosage of 0.1 mmol/kg bodyweight at a rate of 3.0 mL/s.Ktrans and Ve were calculated from the DCE MRI data.The results of Ktrans and Ve were compared between the 2 types of tumors.Receiver operating characteristic curve analysis was performed for each of the variables in differentiation cerebral metastasis from HGG.Results The Ktrans values in the parenchyma of HGG and metastases were 0.10 (0.11,0.71)min-1 and 0.21 (0.05, 0.77)min-1 ,respectively.The difference was not statistically significant (P>0.05).The Ktrans values in the peritumoral region of the HGG and brain metastasis were 0.04 (0.01,0.10)min-1 and 0.01 (0.00,0.06)min-1 ,respectively.There was a significant difference between the Ktrans values in the peritumoral edema of HGG and cerebral metastases (P<0.05).The optimal cutoff value of Ktrans for differentiating HGG from cerebral metastases was 0.03,with sensitivity of 75% and specificity of 70%.Conclusion Ktrans values in the peritumoral edema may be useful in the differentiating cerebral metastases between HGG.