磁共振动态对比增强联合弥散加权成像对单发脑转移瘤和胶质母细胞瘤的诊断价值-现代医学

磁共振动态对比增强联合弥散加权成像对单发脑转移瘤和胶质母细胞瘤的诊断价值

单位：1. 邯郸市中心医院 CT室, 河北邯郸 056001;
2. 邯郸市中心医院核医学科, 河北邯郸 056001

分类号：R445.2;R739.41

出版年·卷·期（页码）：2019·47·第十二期（1461-1465）

摘要：

目的： 分析磁共振动态对比增强（DCE-MRI）联合弥散加权成像（DWI）对单发脑转移瘤和胶质母细胞瘤的鉴别诊断价值。方法： 回顾性分析2013年1月至2017年12月在本院经手术病理证实的脑肿瘤患者160例，其中胶质母细胞瘤120例，单发脑转移瘤40例，所有患者均行常规磁共振成像（MRI）、DCE-MRI、DWI检查，应用软件计算肿瘤实质区和肿瘤周围区的容积转运常数（K^trans）、回流速率常数（K_ep）、血管外容积分数（V_e）及表观弥散系数（ADC）值，采用受试者工作特征（ROC）曲线分析各指标单独及联合应用对单发脑转移瘤和胶质母细胞瘤的鉴别诊断价值。结果： 胶质母细胞瘤和单发脑转移瘤实质区K^trans、K_ep、V_e及ADC值比较差异无统计学意义（P>0.05），瘤周围区K^trans、K_ep、V_e及ADC值比较差异有统计学意义（P<0.05）；ROC分析显示，K^trans值和ADC值联合诊断胶质母细胞瘤的ROC曲线下面积（AUC）最大，为0.935（95%CI 0.894~0.968），敏感性和特异性分别为89.33%、91.02%，其联合诊断的AUC大于其分别单独诊断的AUC（P<0.05）。结论： DCE-MRI联合DWI能够有效提高胶质母细胞瘤和单发脑转移瘤的鉴别诊断效率。

Objective: To analyze the value of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) combined with diffusion weighted imaging (DWI) in the differential diagnosis of single brain metastases and glioblastoma.Methods: A retrospective analysis was made on 160 patients with brain tumors confirmed by operation and pathology in our hospital from January 2013 to December 2017, included 120 cases of glioblastoma and 40 cases of single brain metastasis. All patients underwent routine MRI, DCE-MRI, and DWI examinations, the volume transport constant (K^trans), reflux rate constant (K_ep), vascular volume integral (V_e), and apparent diffusion coefficient (ADC) were calculated by software, the differential diagnostic values of individual and combined detections for single brain metastasis and glioblastoma were analyzed by receiver operating characteristic (ROC) curve. Results: There was no significant difference in K^trans, K_ep, V_e and ADC value in solid area between glioblastoma and single brain metastasis (P>0.05), there were significant differences in K^trans, K_ep, V_e and ADC value in peritumoral area (P<0.05); ROC analysis showed that the maximum area under the ROC curve (AUC) of combined detection of K^trans and ADC in the diagnosis of glioblastoma was 0.935 (95% CI 0.894-0.968), the sensitivity and specificity were 89.33% and 91.02% respectively, the AUC of combined diagnosis was higher than that of single diagnosis (P<0.05). Conclusion: DCE-MRI combined with DWI can effectively improve the differential diagnosis efficiency of glioblastoma and single brain metastasis.

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