摘要
目的：探讨高、低级别星形细胞瘤瘤周区CT灌注成像（CTP）参数的差异及其病理基础。方法：对30例手术与病理证实的脑星形细胞瘤（低级别星形细胞瘤10例、高级别星形细胞瘤20例）行术前CT平扫、增强及CTP检查，测量强化区近侧1cm处或低强化区距边缘1cm处的脑血流量（CBF）、脑血容量（CBV）、平均通过时间（MTT）及脑血管表面通透性（PS）值。比较高、低级别脑星形细胞瘤瘤周区CTP参数差异。对照影像学，采用肿瘤切除前活检的方法取得标本，观察瘤周区病理表现。结果：高级别星形细胞瘤瘤周区CBF、CBV、MTT及PS值高于低级别星形细胞瘤瘤周区。CBF、CBV、MTT及PS值，高级别星形细胞瘤瘤周区分别为（50.05±14.05）ml?蛐（min·100g）、（3.50±1.79）ml?蛐100g、（5.84±2.95）s及（1.23±1.75）ml?蛐（min·100g），低级别星形细胞瘤瘤周区分别为（25.20±8.67）ml?蛐（min·100g）、（1.61±0.68）ml?蛐100g、（4.83±1.63）s及（0.33±0.27）ml?蛐（min·100g），二组间CBF、CBV差异有统计学意义（P<0.05）。组织学上，高级别与低级别星形细胞瘤瘤周区均可见散在肿瘤细胞，前者肿瘤细胞密度较大、血管较多。结论：高级别与低级别脑星形细胞瘤瘤周区CBF、CBV有明显差别，其病理基础不同。
Abstract
Objective: To probe the difference of CT perfusion(CTP) parameters of peritumoral area between high- and low-grade intracranial astrocytoma, and to explore the pathologic basis. Methods: Thirty cases of intracranial asytrocytoma, proven by surgery and pathologic examination, including 10 cases of low-grade tumors(WHO grade Ⅰ and Ⅱ) and 20 cases of high-grade tumors, were examined for precontrast CT, postcontrast CT and CTP. We mearsured the CTP parameters, including CBF, CBV, MTT and PS at the area of 1cm from the margin of enhancement or the margin of the non-enhanced lesion. Paired t test was made for comparison of the CTP parameters of high- and low-grade astrocytoma with the software SPSS 17.0 for refering CTP and postcontrast CT maps, biopsy was made before incision. And the pathologic findings of peritumoral area was observed. Results: CBF, CBV, MTT and PS of peritumoral area of high- grade astrocytoma were higher than those of low-grade astrocytoma. The CBF, CBV, MTT and PS value, peritumoral area of high-grade astrocytoma were(50.05±14.05)ml/(min·100g), (3.50±1.79)ml/100g, (5.84±2.95)s and (1.23±1.75)ml/(min·100g) respectively. And low-grade astrocytoma were (25.20±8.67)ml/(min·100g), (1.61±0.68)ml/100g, (4.83±1.63)s and (0.33±0.27)ml/(min·100g) respectively. There were significant difference of CBF and CBV between high- and low-grade astrocytoma(P<0.05). But no obvious difference was found for MTT and PS between high- and low-grade astrocytoma(P>0.05). Discrete tumor cells were detected in peritumoral area for both high- and low-grade astrocytoma. Whereas more neoplastic cells and vascularity were found in peritumoral area of high-grade astrocytoma. Conclusion: Because of different pathologic basis, there was significant distinction of CTP parameters of peritumoral area between high- and low-grade astrocytoma. This distinction is due to their different findings on pathology.
关键词
脑肿瘤 /
星形细胞瘤 /
体层摄影术 /
X线计算机
Key words
Brain neoplasms /
Astrocytoma /
Tomography /
X-ray computed
袁 涛;王巍巍;全冠民;赵 宁;高丽娟.
高、低级别脑星形细胞瘤瘤周区CTP研究[J]. 中国临床医学影像杂志. 2011, 22(10): 685-688
YUAN Tao;WANG Wei-wei;QUAN Guan-min;ZHAO Ning;GAO Li-juan.
Comparative study of peritumoral area of high- and low-grade astrocytoma with CTP[J]. Journal of China Clinic Medical Imaging. 2011, 22(10): 685-688
中图分类号：
Ｒ739.41
Ｒ730.264
Ｒ814.42
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