摘要
目的：探讨联合应用磁共振灌注成像（Perfusion weighted imaging，PWI）、弥散成像（Diffusion weighted imaging，DWI）鉴别胶质瘤复发与放射性损伤的价值。方法：52例脑胶质瘤术后放疗患者，对放疗后影像随访过程中首次出现异常强化病灶的患者进行常规MR及PWI、DWI检查，测量病灶强化区域的最大相对脑血容积（rCBVmax）值、强化实质区的最小ADC（ADCmin）值，根据病理及临床随诊结果，分析联合应用PWI与DWI在肿瘤复发与放射性损伤中的价值。结果：52例患者中，胶质瘤复发30例，放射性损伤22例，肿瘤复发区rCBVmax值为2.43±1.52、ADCmin值为0.86±0.21，与放射性损伤的rCBVmax值0.67±0.44、ADCmin值1.17±0.27均具有显著性差异（P=0.000），DWI诊断准确率为76.9%，PWI诊断准确率为82.7%，两者联合应用的诊断准确率为90.4%。结论：DWI与PWI可用于脑胶质瘤复发与放射性损伤的鉴别诊断，二者联合应用能够提高诊断的准确率。
Abstract
Objective: To evaluate the value of MR perfusion weighted imaging(PWI) combined with MR diffusion weighted imaging(DWI) in the diagnosis of cerebral glioma recurrence and radiation injuries. Methods: Fifty-two patients who had cerebral gliomas were treated with radiotherapy after operation. They underwent routine MR, PWI and DWI due to the discovery of new lesions after radiotherapy. The value of rCBVmax and ADCmin in the new lesion were measured. According to pathology and clinical follow up, the value of combined PWI and DWI in differentiating tumor recurrence and radiation injury were analyzed. Results: In the 52 cases, recurrence of cerebral glioma were 30 cases, radiation injury 22 cases. The rCBVmax value in the recurrent lesion was 2.43±1.52, the value of ADCmin was 0.86±0.21, while the rCBVmax in the radiation injured lesion was 0.67±0.44, and the ADCmin value was 1.17±0.27, there were statistical differences, P=0.000. The accuracy rate of DWI and PWI were 76.9% and 82.7% respectively, the accuracy rate of combined PWI and DWI was 90.4%. Conclusion: MR PWI and DWI are valuable in differentiating recurrent cerebral glioma and radiation injury, combined the two sequences can raise up the accuracy rate of diagnosis.
关键词
脑肿瘤 /
神经胶质瘤 /
磁共振成像
Key words
Brain neoplasms /
Glioma /
Magnetic resonance imaging
沙 琳;范国光;曹 倩;边 杰.
联合应用PWI与DWI鉴别胶质瘤复发与放射性损伤[J]. 中国临床医学影像杂志. 2013, 24(12): 841-845
SHA Lin;FAN Guo-guang;CAO Qian;BIAN Jie.
MR perfusion weighted imaging combined with MR diffusion weighted imaging in differentiating recurrent cerebral gliomas and radiation injury[J]. Journal of China Clinic Medical Imaging. 2013, 24(12): 841-845
中图分类号：
Ｒ739.41
Ｒ730.264
Ｒ445.2
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