3D-ASL技术在脑胶质瘤术后复发与放射性脑损伤中的鉴别诊断价值
摘要
目的评价磁共振三维动脉自旋标记成像(3D-ASL)对脑胶质瘤术后放疗后复发与放射性脑损伤的鉴别诊断价值。方法对21例脑胶质瘤术后放疗后患者同时行常规MRI增强扫描和3D-ASL检查,测量异常强化区域及对侧正常脑组织的脑血流量(CBF)值,并进行标准化。结果 21例胶质瘤术后放疗后患者常规MRI增强扫描均出现异常强化灶,8例为术后复发,13例为放射性损伤。复发患者的平均r CBF值为2.23±0.35,放射性脑损伤患者平均r CBF值为0.91±0.21,两者差异有统计学意义(P<0.05)。结论 3D-ASL技术对胶质瘤术后放疗后复发与放射性脑损伤有很大的鉴别诊断价值。
引文
[1]马进,张翱.3D-ASL技术的研究进展及临床应用[J].国际医学放射学杂志,2015,38(1):50-53.
[2]Combs SE,Widmer V,Thilmann C,et al.Stereotactic radiosurgery(SRS):treatment option for recurrent glioblastoma multiforme(GBM)[J].Cancer,2005,104(10):2168-2173.
[3]Nieder C,Andratschke N,Price RE,et al.Innovative prevention strategies for radiation necrosis of the central nervous system[J].Anticancer Res,2002,22(2A):1017-1023.
[4]Hu LS,Baxter LC,Smith KA,et al.Relative cerebral blood volume values to differentiate highgrade glioma recurrence from post-treatment radiation effect:direct correlation between image-guided tissue histopathology and localized dynamic susceptibility weighted contrast enhanced perfusion MR imaging measurements[J].Am J Neuroradiol,2009,30(4):552-558.
[5]Sugahara T,Komgi Y,Kochi M,et a1.Relationship of Mlt determined cerebral blood volume maps to histologic and angiographic vascularitics of gliomas[J].AJR,1998,171:1479-1486.
[6]Bobek-Billewicz B,Stasik-Pres G,Majchrzak H,et al.Differentiation between brain tumor recurrence and radiation injury using perfusion,diffusion-weighted imaging and MR spectroscopy[J].Foila Neuropathol,2010,48(2):81-92.
[7]郑斐群,余永强,钱银锋.MR灌注成像在评价脑内胶质瘤残留或复发方面的价值[J].临床放射学杂志,2006,25(6):493-496.
[8]徐俊玲,陈传亮,连建敏,等.磁共振灌注加权成像鉴别脑胶质瘤术后放疗后复发的价值[J].中华放射肿瘤学杂志,2012,21(4):306-309.
[9]Forsyth PA,Kelly PJ,Cascino TL,et a1.Badialion necrosis or glioma recurrence:is computer assisted stereotactic biopsy useful[J]?J Neurosurg,1995,82:436.
[10]Sugahara T,Korogi Y,Tomiguehi S,et a1.Posttherapeutie intrsaxial brain tumor:the value of perfusion-sensitive contrast-enhanced MR imaging for differentiating tumor recurrence from nonneoplastic contrast-enhancing tissue[J].AJNB,2000,21:901-909.
[11]张秀明,戴峰,乔伟,等.磁共振功能成像在鉴别脑胶质瘤术后复发与放射性损伤中的应用[J].中国医学影像学杂志,2013,21(3):161-165.
[2]Combs SE,Widmer V,Thilmann C,et al.Stereotactic radiosurgery(SRS):treatment option for recurrent glioblastoma multiforme(GBM)[J].Cancer,2005,104(10):2168-2173.
[3]Nieder C,Andratschke N,Price RE,et al.Innovative prevention strategies for radiation necrosis of the central nervous system[J].Anticancer Res,2002,22(2A):1017-1023.
[4]Hu LS,Baxter LC,Smith KA,et al.Relative cerebral blood volume values to differentiate highgrade glioma recurrence from post-treatment radiation effect:direct correlation between image-guided tissue histopathology and localized dynamic susceptibility weighted contrast enhanced perfusion MR imaging measurements[J].Am J Neuroradiol,2009,30(4):552-558.
[5]Sugahara T,Komgi Y,Kochi M,et a1.Relationship of Mlt determined cerebral blood volume maps to histologic and angiographic vascularitics of gliomas[J].AJR,1998,171:1479-1486.
[6]Bobek-Billewicz B,Stasik-Pres G,Majchrzak H,et al.Differentiation between brain tumor recurrence and radiation injury using perfusion,diffusion-weighted imaging and MR spectroscopy[J].Foila Neuropathol,2010,48(2):81-92.
[7]郑斐群,余永强,钱银锋.MR灌注成像在评价脑内胶质瘤残留或复发方面的价值[J].临床放射学杂志,2006,25(6):493-496.
[8]徐俊玲,陈传亮,连建敏,等.磁共振灌注加权成像鉴别脑胶质瘤术后放疗后复发的价值[J].中华放射肿瘤学杂志,2012,21(4):306-309.
[9]Forsyth PA,Kelly PJ,Cascino TL,et a1.Badialion necrosis or glioma recurrence:is computer assisted stereotactic biopsy useful[J]?J Neurosurg,1995,82:436.
[10]Sugahara T,Korogi Y,Tomiguehi S,et a1.Posttherapeutie intrsaxial brain tumor:the value of perfusion-sensitive contrast-enhanced MR imaging for differentiating tumor recurrence from nonneoplastic contrast-enhancing tissue[J].AJNB,2000,21:901-909.
[11]张秀明,戴峰,乔伟,等.磁共振功能成像在鉴别脑胶质瘤术后复发与放射性损伤中的应用[J].中国医学影像学杂志,2013,21(3):161-165.