CAJ | 학술논문

目的：探讨 MRI 动态增强扫描定量参数对脑胶质瘤病理分级的诊断价值。方法：经手术病理证实的脑胶质瘤患者19例，其中高级别胶质瘤（HGG）12例，低级别胶质瘤（LGG）7例。所有患者均行常规 MRI 平扫及 MRI 动态增强（DCE）扫描。利用北京大学前沿交叉学科研究院开发的 Ktrans 计算系统，分别测量颅内占位性病变实质区及瘤周水肿区的 Ktrans 值和 Ve 值。不同级别胶质瘤 Ktrans 值的比较采用 Mann-Whitney U 检验。采用受试者工作特征曲线（ROC）对 Ktrans 和 Ve 值进行分析。结果：HGG 及 LGG 组的 Ktrans 值分别为（0．24±0．17）和（0．07±0．04）min-1，差异有统计学意义（t＝2．625，P ＝0．018）；Ve 分别为0．92±0．15和0．50±0．25，差异有统计学意义（t＝4．613，P ＜0．001）；Ktrans以0．12 min-1为阈值，诊断敏感度为83％，特异度为86％；Ve 以0．88为阈值，敏感度为83％，特异度为85％。结论：采用Ktrans 值结合常规 MRI 序列，对于胶质瘤的分级诊断具有一定的临床应用价值。
목적：탐토 MRI 동태증강소묘정량삼수대뇌효질류병리분급적진단개치。방법：경수술병리증실적뇌효질류환자19례，기중고급별효질류（HGG）12례，저급별효질류（LGG）7례。소유환자균행상규 MRI 평소급 MRI 동태증강（DCE）소묘。이용북경대학전연교차학과연구원개발적 Ktrans 계산계통，분별측량로내점위성병변실질구급류주수종구적 Ktrans 치화 Ve 치。불동급별효질류 Ktrans 치적비교채용 Mann-Whitney U 검험。채용수시자공작특정곡선（ROC）대 Ktrans 화 Ve 치진행분석。결과：HGG 급 LGG 조적 Ktrans 치분별위（0．24±0．17）화（0．07±0．04）min-1，차이유통계학의의（t＝2．625，P ＝0．018）；Ve 분별위0．92±0．15화0．50±0．25，차이유통계학의의（t＝4．613，P ＜0．001）；Ktrans이0．12 min-1위역치，진단민감도위83％，특이도위86％；Ve 이0．88위역치，민감도위83％，특이도위85％。결론：채용Ktrans 치결합상규 MRI 서렬，대우효질류적분급진단구유일정적림상응용개치。
Objective:To evaluate the value of dynamic enhanced MR scanning with transfer coefficient (Ktrans)in the diagnosis of histopathology grading of cerebral glioma.Methods:Nineteen patients with pathology confirmed cerebral glioma (high-grade glioma,HGG,n=12;low-grade glioma,LGG,n=7 )underwent plain and dynamic contrast-enhanced MR scanning.Peking University First Hospital medical ethical committees approved the study.Ktrans system developed by Peking University was used to measured the Ktrans and Ve of intra-cerebral space occupying lesion and peri-tumoral edema respectively.Mann-Whitney U test was used to compared the Ktrans value of glioma with different pathology grading.Re-ceiver operating characteristic curve (ROC)were performed for the analysis of Ktrans and Ve values.Results:The Ktrans values of HGG and LGG were (0.24±0.17)and (0.07±0.04)min-1 respectively,with significant statistic difference (t=2.625,P =0.018).The Ve of HGG and LGG was 0.92 ±0.15 and 0.50 ±0.25 respectively,with significant statistical difference (t=2.625,P <0.001).Using 0.12 as cut-off value of Ktrans for differentiating LGG from HGG,the sensitivity was 83%,and specificity was 86%.With 0.88 as the cutoff value of Ve,the sensitivity was 83%,specificity was 85%.Con-clusion:Ktrans value in combination with routine MR scanning is helpful in the pathology grading of cerebral glioma,with clinical significance.