128层CT灌注成像与MRI多序列结合对胶质瘤分级的诊断价值

摘要

目的 探讨128层CT灌注成像与MRI序列联合评估胶质瘤术前分级的诊断价值.方法 回顾性分析经病理学检查确诊的胶质瘤术前MRI图像和CT灌注图像,分别研究MRI的序列敏感加权成像(SWI)、扩散加权成像(DWI)与CT灌注图像对胶质瘤术前分级的准确率,对比分析MRI序列与联合评估对胶质瘤术前分级的准确率.结果 SWI对高级别胶质瘤出血和钙化的发现率均高于低级别胶质瘤,差异有统计学意义(P﹤0.05);表观弥散系数(ADC)值在高、低级别胶质瘤之间和Ⅲ级与Ⅳ级胶质瘤之间比较,差异有统计学意义(P﹤0.05).脑血流量(CBF)和脑血容量(CBV)在高、低级别胶质瘤之间比较,差异有统计学意义(P﹤0.05),但在Ⅰ级与Ⅱ级胶质瘤之间和Ⅲ级与Ⅳ级胶质瘤之间比较,差异无统计学意义(P﹥0.05).对低级别(Ⅰ和Ⅱ级)胶质瘤术前分级,MRI联合CT灌注成像评估的准确率高于单纯MRI评估,差异有统计学意义(P﹤0.05).结论 MRI联合CT灌注成像对胶质瘤术前分级具有更高的准确率.%Objective To explore the diagnostic value of 128-slice CT perfusion imaging in combination with multi-sequence MRI in the assessment of the preoperative staging of glioma.Method A retrospective analysis was conducted to analyze the preoperative MRI imaging and CT perfusion imaging in pathologically confirmed glioma before surgery, the accuracy of susceptibility weighted imaging(SWI)and diffusion weighted imaging(DWI)of MRI and CT perfusion imaging in the preoperative staging of glioma were determined respectively,and an comparative analysis of the accuracy of preoperative staging for glioma between the MRI sequence imaging and the combined assessment of MRI and CT per-fusion imaging was performed.Result Higher detection rate of calcification and hemorrhage in glioma of higher grade then in lower grade was observed using SWI,and the difference was statistically significant(P<0.05);the ADC value was of statistically significant difference between higher and lower grade,as well as gradeⅢand gradeⅣgliomas(P<0.05). CBF and CBV were significantly different between higher and lower grade gliomas(P<0.05),but there was no significant difference between grade I andⅡ,and between gradeⅢandⅣgliomas(P>0.05).The combined assessment conferred superior accuracy for lower grade(I andⅡ)gliomas(P<0.05).Conclusion The combined assessment using MRI and CT perfusion is relatively more accurate in the determination of preoperative staging of glioma.