颅内肿瘤患者的MRI影像学特征与预后的相关性
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摘要
目的探讨颅内肿瘤患者的MRI影像学特征与预后的相关性。方法采用回顾性调查研究方法,选取颅内肿瘤患者52例作为颅内肿瘤组,选择同期进行体检的健康人52例作为对照组,记录2组的MRI影像学特征,颅内肿瘤患者在治疗后3个月进行预后认知功能判定与相关性分析。结果颅内肿瘤组与对照组的MoCA评分分别为(21.24±4.28)分和(28.11±1.98)分,颅内肿瘤组低于对照组(P <0.05)。颅内肿瘤组的脑白质疏松1级、2级、3级、4级患者分别为12例、14例、16例与10例,对照组分别为46例、5例、1例与0例,对比差异有统计学意义(P <0.05)。在颅内肿瘤组中,MRI显示瘤内血管流空、瘤周水肿、瘤内出血、囊变坏死所占比例分别为88.5%、65.4%、84.6%、76.9%。Pearson相关分析结果显示MoCA评分与MRI脑白质疏松分级呈现明显正相关性(P <0.05),也与瘤内血管流空、瘤周水肿、瘤内出血、囊变坏死呈现明显负相关性(P <0.05)。结论颅内肿瘤患者在预后存在明显的认知障碍,MRI影像学特征主要表现为脑白质疏松异常、瘤内血管流空、瘤周水肿,且MRI影像学特征与预后认知障碍存在明显相关性。
Objective To investigate the correlation between MRI imaging features and prognosis in patients with intracranial tumors.Methods Used a retrospective study,52 cases of patients with intracranial tumor were selected as intracranial tumor group,and the other 52 healthy people for medical examination were selected as the control group,recorded the MRI imaging features,3 months after treatment,the prognosis of cognitive function were given determination and correlation analysis.Results The MoCA scores in the intracranial tumor group and the control group were( 21.24 ± 4.28) points and( 28.11 ± 1.98)points,respectively,and the intracranial tumor group was lower than that of the control group( P < 0.05).There were 12 patients,14 patients,16 patients and 10 patients of WMLs grade 1,2,3 and 4 in the intracranial tumor group,so that were 10 were 46 patients,5 patients,1 patients and 0 patients respectively in the control group,and compared the difference were significant( P <0.05).In the intracranial tumor group,MRI showed intratumoral vascular flow,peritumoral edema,intratumoral hemorrhage,cystic necrosis accounted for 88.5%,65.4%,84.6%,76.9%; Pearson correlation analysis showed that MoCA score and WMLs grade were showed significant positive correlation( P < 0.05),and were significant positive correlation to the MRI intratumoral vascular flow,peritumoral edema,intratumoral hemorrhage,cystic necrosis.Conclusion There are obvious cognitive impairment in patients with intracranial tumors in the prognosis,MRI imaging showed WMLsabnormalities,intratumoral vascular flow,peritumoral edema,and the MRI imaging features are significantly related to the prognosis of cognitive impairment.
Objective To investigate the correlation between MRI imaging features and prognosis in patients with intracranial tumors.Methods Used a retrospective study,52 cases of patients with intracranial tumor were selected as intracranial tumor group,and the other 52 healthy people for medical examination were selected as the control group,recorded the MRI imaging features,3 months after treatment,the prognosis of cognitive function were given determination and correlation analysis.Results The MoCA scores in the intracranial tumor group and the control group were( 21.24 ± 4.28) points and( 28.11 ± 1.98)points,respectively,and the intracranial tumor group was lower than that of the control group( P < 0.05).There were 12 patients,14 patients,16 patients and 10 patients of WMLs grade 1,2,3 and 4 in the intracranial tumor group,so that were 10 were 46 patients,5 patients,1 patients and 0 patients respectively in the control group,and compared the difference were significant( P <0.05).In the intracranial tumor group,MRI showed intratumoral vascular flow,peritumoral edema,intratumoral hemorrhage,cystic necrosis accounted for 88.5%,65.4%,84.6%,76.9%; Pearson correlation analysis showed that MoCA score and WMLs grade were showed significant positive correlation( P < 0.05),and were significant positive correlation to the MRI intratumoral vascular flow,peritumoral edema,intratumoral hemorrhage,cystic necrosis.Conclusion There are obvious cognitive impairment in patients with intracranial tumors in the prognosis,MRI imaging showed WMLsabnormalities,intratumoral vascular flow,peritumoral edema,and the MRI imaging features are significantly related to the prognosis of cognitive impairment.
引文
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[22]晏颖,邓宇,李新春,等.1H-MRS在颅脑常见肿瘤诊断中的临床应用研究[J].中国CT和MRI杂志,2017,15(6):5-7.
[2]Riggs L,Piscione J,Laughlin S,et al.Exercise training for neural recovery in arestricted sample of pediatric brain tumor survivors:a controlled clinical trialwith crossover of training versus no training[J].Neuro Oncol,2017,19(3):440-450.
[3]董娜,张贵丽,张宏伟.轻度认知障碍的神经心理表现及解剖结构损害的分型研究[J].中风与神经疾病杂志,2016,33(1):49-53.
[4]Bells S,Lefebvre J,Prescott SA,et al.Changes in white matter microstructure impact cognition by disrupting the ability of neural assemblies to synchronize[J].J Neurosci,2017,37(34):8227-8238.
[5]Brown PD,Ballman KV,Cerhan JH,et al.Postoperative stereotactic radiosurgery compared with whole brainradiotherapy for resected metastatic brain disease(NCCTG N107C/CEC·3):amulticentre,randomised,controlled,phase 3 trial[J].Lancet Oncol,2017,18(8):1049-1060.
[6]唐坤,徐雅莉,郑祥武,等.MRI对颅内脉络丛乳头状瘤的诊断价值[J].温州医科大学学报,2017,47(3):215-217.
[7]Cao Y,Tseng CL,Balter JM,et al.MR-guided radiationtherapy:transformative technology and its role in the central nervous system[J].Neuro Oncol,2017,19(suppl_2):16-19.
[8]Seibert TM,Karunamuni R,Kaifi S,et al.Cerebral cortex regions selectively vulnerable to radiation dose-dependent atrophy[J].Int J Radiat Oncol Biol Phys,2017,97(5):910-918.
[9]朱芳梅,丁菊容,袁建华,等.颅内肿瘤脑脊液播散的MRI表现及影响因素[J].实用放射学杂志,2017,33(2):165-168.
[10]Redmond KJ,Hales RK,Anderson-Keightly H,et al.Prospective study of hippocampal-sparing prophylactic cranial irradiation in limited-stage small cell lung cancer[J].Int JRadiat Oncol Biol Phys,2017,98(3):603-611.
[11]Butts AM,Weigand S,Brown PD,et al.Neurocognition in individuals with incidentally-identified meningioma[J].JNeurooncol,2017,134(1):125-132.
[12]朱辉严,谌力群,许平,等.颅内孤立性纤维瘤的临床、病理和影像学表现[J].现代医用影像学,2017,26(2):305-307.
[13]Menning S,de Ruiter MB,Veltman DJ,et al.Changes in brain activation in breast cancer patients depend oncognitive domain and treatment type[J].PLoS One,2017,12(3):e0171724.
[14]Ajithkumar T,Price S,Horan G,et al.Prevention ofradiotherapy-induced neurocognitive dysfunction in survivors of paediatric brain tumours:the potential role of modern imaging and radiotherapy techniques[J].Lancet Oncol,2017,18(2):e91-e100.
[15]浦智韬,金中高,陈松平.颅内原始神经外胚层肿瘤的CT和MRI影像学表现[J].医学影像学杂志,2017,27(1):165-167.
[16]Peddi P,Ajit NE,Burton GV,et al.Regression of a glioblastomamultiforme:spontaneous versus a potential antineoplastic effect of dexamethasoneand levetiracetam[J].BMJ Case Rep,2016,12(23):2016.
[17]Hauser SL,Bar-Or A,Comi G,et al.Ocrelizumab versus Interferon beta-1a in relapsing multiple sclerosis[J].N Engl JMed,2017,376(3):221-234.
[18]冯秀霞.探讨颅内原发性淋巴瘤核磁共振成像诊断及鉴别诊断价值[J].临床研究,2017,25(2):50-51.
[19]Cipolotti L,SpanòB,Healy C,et al.Inhibition processes are dissociable andlateralized in human prefrontal cortex[J].Neuropsychologia,2016,93(Pt A):1-12.
[20]赵瑞华,黄立雪,吴俊峰,等.CT和MRI诊断颅内鞍区肿瘤的价值对比研究[J].中国CT和MRI杂志,2017,15(4):10-13.
[21]Wefel JS,Noll KR,Rao G,et al.Neurocognitive function varies by IDH1 genetic mutation status in patients with malignant glioma prior to surgicalresection[J].Neuro Oncol,2016,18(12):1656-1663.
[22]晏颖,邓宇,李新春,等.1H-MRS在颅脑常见肿瘤诊断中的临床应用研究[J].中国CT和MRI杂志,2017,15(6):5-7.