[1]李永丽,连建敏,窦社伟,等.脑胶质瘤术后放疗后复发和放射性脑坏死磁共振弥散张量成像鉴别*[J].郑州大学学报(医学版),2013,(03):362.
　LI Yongli,LIAN Jianmin,DOU Shewei,et al.Distinction between brain glioma recurrence and radiation necrosis after postoperative radiotherapy using MR diffusion tensor imaging[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2013,(03):362.
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脑胶质瘤术后放疗后复发和放射性脑坏死磁共振弥散张量成像鉴别*
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2013年03期
页码:
362
栏目:
应用研究
出版日期:
2013-06-20

文章信息/Info

Title:
Distinction between brain glioma recurrence and radiation necrosis after postoperative radiotherapy using MR diffusion tensor imaging
作者:
李永丽; 连建敏; 窦社伟; 闫峰山; 史大鹏; 徐俊玲#
河南省人民医院放射科 郑州 450003
Author(s):
LI Yongli; LIAN Jianmin; DOU Shewei; YAN Fengshan; SHI Dapeng; XU Junling
Department of Radiology，Henan Provincial People's Hospital，Zhengzhou 450003
关键词:
磁共振弥散张量成像;  肿瘤复发; 脑胶质瘤; 鉴别
Keywords:
MR diffusion tensor imaging; neoplasm recurrence;  brain glioma; distinguish
分类号:
R816.1
摘要:
摘要目的：评价磁共振弥散张量成像(DTI)对胶质瘤术后放疗后复发和放射性脑坏死的鉴别价值。方法：对35例脑胶质瘤术后放疗后疑似肿瘤复发者行常规MRI和DTI检查。在表观弥散系数（ADC）图及各相异性分数（FA）图上对应病变强化区、水肿区和对侧半球正常脑白质区（对照）选择感兴趣区，测量ADC值和FA值，计算病变强化区和水肿区标准化ADC比值和FA比值，行受试者工作特征（ROC）曲线分析。结果：经组织学检查及胶质瘤术后随访，确定胶质瘤复发20例、放射性脑坏死15例。肿瘤复发组病变强化区ADC比值（1.34±0.15）低于放射性脑坏死组（1.62±0.17）（t=5.162，P<0.001），FA比值（0.45±0.03）高于放射性脑坏死组（0.32±0.03）(t=12.686，P<0.001)。2组水肿区以上2指标差异无统计学意义。ROC曲线分析结果显示，以病变强化区ADC比值<1.65和（或）FA比值>0.36判断肿瘤复发时，DTI的诊断敏感性、特异性和准确性分别为85.0%(17/20)、86.7%(13/15)和85.7%（30/35）。结论：DTI对鉴别胶质瘤术后放疗后复发和放射性脑坏死有重要的应用价值。
Abstract:
AbstractAim: To evaluate the value of MR diffusion tensor imaging(DTI) to distinguish brain glioma recurrent from radiation necrosis after postoperative radiotherapy. Methods: Thirtyfive patients of brain glioma (20 true, 15 false) were examined by conventional MRI and DTI. Regions of interest (ROI) were manually drawn in the regions of contrastenhancing lesion, close edema and the contralateral semisphere corresponding normal white matter on the ADC and FA maps, respectively. ADC and FA values of ROI were measured. Then the standardized ADC and FA ratios were calculated. The receiver operating characteristic curves were analyzed. Results: The mean ADC ratio (1.34±0.15) in the contrastenhancing lesions was significantly lower in patients with tumor recurrence compared with those with radiation necrosis (1.62±0.17)(t=5.162，P<0.001). The mean FA ratio（0.45±0.03）in the contrastenhancing lesions was significantly higher in patients with tumor recurrence compared with those with radiation necrosis (0.32±0.03)(t=12.686，P<0.001). Neither the mean ADC nor FA ratio in edema had statistical difference between the two groups. Tumor recurrence was suggested when either ADC ratio <1.65 or/and FA ratio>0.36 according to ROC curve analysis of contrastenhancing lesions, and the diagnostic sensitivity, specificity and accuracy for recurrent tumor of DTI were 85.0%, 86.7% and 85.7%.Conclusion: MR DTI examination is valuable to distinguish brain glioma recurrence from radiation necrosis.

参考文献/References:

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备注/Memo

备注/Memo:
*河南省卫生科技攻关计划基金资助项目2011020142；201003101
#通讯作者，女，1965年9月生，主任医师，研究方向：中枢神经系统的影像学诊断，Email：xjlhzq@163.com
更新日期/Last Update: 2013-07-03