CAJ | 학술논문

目的评估磁共振氨基质子转移(APT)成像在鉴别脑单发转移瘤与高级别神经上皮肿瘤方面的应用价值.方法收集2013年3月至2014年3月南方医科大学珠江医院神经外科收治的脑单发转移瘤和高级别神经上皮肿瘤病例共83例,选取病灶的最大层面行APT序列扫描,将经手术病理证实的34例脑转移瘤(34个病灶)和49例高级别神经上皮肿瘤(49个病灶)APT图像结合常规MRI图像划分出瘤核心区和瘤旁区两个感兴趣区域,测量APT转移率(APTR)并构建伪彩图,分别比较转移瘤与高级别神经上皮肿瘤的瘤核心、瘤旁区的APTR差异.应用受试者特性曲线分析鉴别两者的最佳界值.结果伪彩图示转移瘤组与高级别神经上皮肿瘤组的瘤核心信号强度相近,但两组瘤旁区信号差异较为明显;转移瘤组与高级别神经上皮肿瘤组瘤核心区APTR分别为(2.92±0.51)％和(3.06±0.56)％,两者之间差异无统计学意义(P=0.233);转移瘤组和高级别神经上皮肿瘤组瘤旁区APrR分别为(1.47±0.23)％和(1.81±0.31)％,两者之间差异有统计学意义(P=0.000).结论 APT成像结合常规序列,特别是量化瘤旁区的APTR,对转移瘤和高级别神经上皮肿瘤的鉴别诊断有一定的临床应用价值.
목적 평고자공진안기질자전이(APT)성상재감별뇌단발전이류여고급별신경상피종류방면적응용개치.방법 수집2013년3월지2014년3월남방의과대학주강의원신경외과수치적뇌단발전이류화고급별신경상피종류병례공83례,선취병조적최대층면행APT서렬소묘,장경수술병리증실적34례뇌전이류(34개병조)화49례고급별신경상피종류(49개병조)APT도상결합상규MRI도상화분출류핵심구화류방구량개감흥취구역,측량APT전이솔(APTR)병구건위채도,분별비교전이류여고급별신경상피종류적류핵심、류방구적APTR차이.응용수시자특성곡선분석감별량자적최가계치.결과 위채도시전이류조여고급별신경상피종류조적류핵심신호강도상근,단량조류방구신호차이교위명현;전이류조여고급별신경상피종류조류핵심구APTR분별위(2.92±0.51)％화(3.06±0.56)％,량자지간차이무통계학의의(P=0.233);전이류조화고급별신경상피종류조류방구APrR분별위(1.47±0.23)％화(1.81±0.31)％,량자지간차이유통계학의의(P=0.000).결론 APT성상결합상규서렬,특별시양화류방구적APTR,대전이류화고급별신경상피종류적감별진단유일정적림상응용개치.
Objective To investigate the application value of identification of the solitary metastatic tumors and the high-grade neuroepithelial tumors with amide proton transfer (APT) magnetic resonance imaging.Methods A total of 83 patients with metastatic tumor and high-level neuroepithelial tumor admitted at the Department of Neurosurgery,Zhujiang Hospital,Southern Medical University from March 2013 to March 2014 were enrolled.The patients with metastatic tumor and high-level neuroepithelial tumor newly diagnosed by conventional magnetic resonance imaging performed APT sequential scan.For the 34 patients with metastatic tumor (34 foci) and 49 patients with high-grade neuroepithelial tumors (49 foci) confirmed by surgery,the APT images divided the tumor core areas and two regions of interest of paratumor areas.The amide proton transfer ratio (APTR) was measured and the pseudo-color images were constructed.The APTR differences of the tumor cores and the paratumor areas between the metastatic tumors and the high-level neuroepithelial tumors were compared respectively using two independent sample t tests.Simultaneously,the receiver operating characteristic curve analysis was used to identify the best cut-off values of both.Results The pseudo-color images showed that the tumor core signal intensity was similar between the metastatic tumor group and the high-grade neuroepithelial tumor group,but the signal difference of the paratumor area was more obvious.The tumor core area APTRs in the metastatic tumor group and the high-grade neuroepithelial tumor group were (2.92 ±0.51)％ and (3.06 ±0.56)％ respectively.There was no significant difference between the two groups (P =0.233).The peritumoral area APTRs in the metastatic tumor group and the high-grade neuroepithelial tumor group were (1.47 ± 0.23)％ and (1.81 ± 0.31)％ respectively.There was significant difference between the two groups(P =0.000).Conclusions APT imaging combined with conventional sequence,in particular the APTR of quantitative paratumor area,has certain clinical value for the differential diagnosis of the metastatic tumors and the high-grade neuroepithelial tumors.