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中华消化病与影像杂志(电子版) ›› 2023, Vol. 13 ›› Issue (04) : 262 -265. doi: 10.3877/cma.j.issn.2095-2015.2023.04.016

论著

三维动脉自旋标记联合动态对比增强MRI对脑胶质瘤术后复发及放射性脑坏死诊断的研究
冯海涛, 徐涛(), 刘文阳, 孙晨, 曹尚超   
  1. 072750 河北省,涿州市医院影像科
  • 收稿日期:2023-01-05 出版日期:2023-08-01
  • 通信作者: 徐涛
  • 基金资助:
    保定市科技计划项目(2141ZF344)

Value of three-dimensional arterial spin labeling combined with DCE-MRI in the diagnosis of postoperative recurrence and radiation brain necrosis of glioma

Haitao Feng, Tao Xu(), Wenyang Liu, Chen Sun, Shangchao Cao   

  1. Department of Imaging, Zhuozhou City Hospital, Zhuozhou 072750, China
  • Received:2023-01-05 Published:2023-08-01
  • Corresponding author: Tao Xu
引用本文:

冯海涛, 徐涛, 刘文阳, 孙晨, 曹尚超. 三维动脉自旋标记联合动态对比增强MRI对脑胶质瘤术后复发及放射性脑坏死诊断的研究[J]. 中华消化病与影像杂志(电子版), 2023, 13(04): 262-265.

Haitao Feng, Tao Xu, Wenyang Liu, Chen Sun, Shangchao Cao. Value of three-dimensional arterial spin labeling combined with DCE-MRI in the diagnosis of postoperative recurrence and radiation brain necrosis of glioma[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(04): 262-265.

目的

分析三维动脉自旋标记(3D-ASL)联合动态对比增强磁共振成像(DCE-MRI)技术诊断脑胶质瘤术后复发与放射性脑坏死的临床价值。

方法

对2019年1月至2021年12月涿州市医院行术后辅助放射治疗的脑胶质瘤患者(60例)的临床资料进行回顾性研究,常规MRI检查发现新增异常强化灶,经二次手术病理检查证实后将其分为脑胶质瘤术后复发组(n=38)与放射性脑坏死组(n=22)。两组患者分别进行MRI、3D-ASL、DCE-MRI检查,获取3D-ASL和DCE-MRI的定量参数,分析应用3D-ASL联合DCE-MRI诊断脑胶质瘤术后复发与放射性脑坏死的临床价值。

结果

脑胶质瘤术后复发组的rCBF、Ktrans值均高于放射性脑坏死组(P<0.05)。3D-ASL联合DCE-MRI检查的准确率高于单一检查(P<0.05)。3D-ASL联合DCE-MRI检查的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于单一检查(P<0.05)。

结论

临床可应用3D-ASL联合DCE-MRI对脑胶质瘤术后复发与放射性脑坏死进行区分,提高诊断准确率。

Objective

To analyze the clinical value of three-dimensional arterial spin labeling(3D-ASL)combined with dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis of recurrence of glioma and radiation brain necrosis.

Methods

Retrospective study was conducted on the clinical data of 60 patients with glioma who received postoperative adjuvant radiotherapy in Zhuozhou City Hospital from January 2019 to December 2021.The new abnormal enhancement lesions were found by routine MRI examination, and they were divided into postoperative recurrence group of glioma(n=38)and radiation brain necrosis group(n=22)after confirmed by secondary surgical pathology.The patients in both groups received MRI, 3D-ASL and DCE-MRI to obtain the quantitative parameters of 3D-ASL and DCE-MRI.The parameters of the two groups were compared and the clinical value of 3D-ASL combined with DCE-MRI in the diagnosis of postoperative recurrence and radiation brain necrosis of glioma was analyzed.

Results

The rCBF and Ktrans values of glioma recurrence group were higher than those of radiation brain necrosis group(P<0.05). The accuracy of 3D-ASL combined with DCE-MRI was higher than that of single examination(P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 3D-ASL combined with DCE-MRI were higher than those of single examination(P<0.05).

Conclusion

3D-ASL combined with DCE-MRI can be used clinically to distinguish the recurrence of brain glioma from radiation brain necrosis.The combined examination of the two has extremely high diagnostic value and can improve the diagnostic accuracy.

图1 患者女性,62岁,胶质母细胞瘤术后10个月复查注:1A~1C为DCE-MRI图像,胼胝体压部及体部稍长T1稍长T2信号,增强扫描明显不均匀强化。1D、1E为3D-ASL图像,病变区明显高灌注,提示肿瘤复发
图2 患者女性,58岁,胶质母细胞瘤术后放疗8个月复查注:2A~2C为DCE-MRI图像,右侧半卵圆中心团块状稍长T1稍长T2信号,增强扫描显示边缘轻度不规则强化,内部坏死区未见强化。2D为3D-ASL图像,病变区呈低灌注,无肿瘤活性,提示病变为放射性坏死
表1 三种检查的诊断效能比较(%)
1
Chen LZeng DXu N,et al.Blood-brain barrier-and blood-brain tumor barrier-penetrating peptide-derived targeted therapeutics for glioma and malignant tumor brain metastases[J].Acs Appl Mater Inter201911(45):41889-41897.
2
De B AAhn B YD′Mello C,et al.Glioma-derived IL-33 orchestrates an inflammatory brain tumor microenvironment that accelerates glioma progression[J].Nat Commun202011(1):4997.
3
白雪菲,高阳,牛广明,等.mTI-ASL技术在鉴别脑胶质瘤术后复发与放射性损伤中的应用价值[J].磁共振成像202011(5):332-335.
4
Wang SShen HMao Q,et al.Macrophage-mediated porous magnetic nanoparticles for multimodal imaging and postoperative photothermal therapy of gliomas[J].Acs Appl Mater Inter202113(48):56825-56837.
5
Chawla SBukhari SAfridi O M,et al.Metabolic and physiologic magnetic resonance imaging in distinguishing true progression from pseudoprogression in patients with glioblastoma[J].Nm Biomed202235(7):4719.
6
中国脑胶质瘤协作组,中国脑胶质瘤基因组图谱计划.中国脑胶质瘤分子诊疗指南[J].中华神经外科杂志201430(5):435-444.
7
Bacanin NBezdan TVenkatachalam K,et al.Optimized convolutional neural network by firefly algorithm for magnetic resonance image classification of glioma brain tumor grade[J].J Real Time Image Process202118(4):1085-1098.
8
Korfiatis PErickson B.Deep learning can see the unseeable:predicting molecular markers from MRI of brain gliomas[J].Clin Radiol201974(5):367-373.
9
张毓,千超,肖三潮,等.超声造影技术和常规超声检查在脑胶质瘤手术切除中的应用比较[J].检验医学与临床202017(8):1121-1124.
10
Mohamud J AGu JHalane S A,et al.Role of MRI in Differentiation between Postoperative Tumoral Recurrence and Radiation-Induced Brain Necrosis in Patients of Glioblastoma Multiform[J].Open J Radiol202111(2):45-53.
11
潘锋,吴晓,苏中周,等.3D-ASL技术联合DWI在鉴别脑胶质瘤术后复发与假性进展中的应用价值[J].临床放射学杂志201837(6):904-908.
12
Lv YTMing XXLv SX,et al.Application of 3D-Arterial Spin Labeling Brain Perfusion Imaging in the Preoperative Diagnosis and Grading of Glioma[J].Indian J Pharm Sci202183(1):83-88.
13
Pang HDang XRen Y,et al.3D-ASL perfusion correlates with VEGF expression and overall survival in glioma patients:Comparison of quantitative perfusion and pathology on accurate spatial location-matched basis[J].J Magn Reson Imaging201950(1):209-220.
14
刘宵雪,张志强,李建瑞,等.动态对比增强磁共振在脑胶质瘤中的研究进展[J].中华医学杂志201797(3):232-234.
15
王大堃,朱建忠,刘辉,等.DCE-MRI测量K~(trans)值、Ve值联合ADC值与脑胶质瘤患者MVD及病理分期的相关性[J].中国临床医学影像杂志202031(11):766-769.
16
Zhang JWang YWang Y,et al.Perfusion magnetic resonance imaging in the differentiation between glioma recurrence and pseudoprogression:A systematic review,meta-analysis and meta-regression[J].Quant Imaging Med Surg202212(10):4805-4822.
17
Miyoshi FShinohara YKambe A,et al.Utility of intravoxel incoherent motion magnetic resonance imaging and arterial spin labeling for recurrent glioma after bevacizumab treatment[J].Acta Radiol201859(11):1372-1379.
18
Kang XXi YLiu T,et al.Grading of Glioma:combined diagnostic value of amide proton transfer weighted,arterial spin labeling and diffusion weighted magnetic resonance imaging[J].Bmc Med Imaging202020(1):1-8.
19
石慧娴,韩雷,叶靖,等.3D-ASL与DSC-PWI在高级别脑胶质瘤术后复发和放射性脑坏死鉴别诊断中的应用[J].肿瘤影像学202029(3):324-329.
20
Liu KShi JJin G.3D-ASL combined with 3.0 T MRI is helpful for preoperative grade and postoperative relapse prediction in glioma[J].Int J Clin Exp Med202013(11):8676-8683.
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