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动脉自旋标记在脑肿瘤分级评估中的诊断意义

Diagnostic significance of arterial spin labeling in the assessment of tumor grade in brain.

作者信息

Wang Yu-Fang, Hou Bo, Yang Su-Jun, Zhang Xiao-Rui, Dong Xiaolei, Zhang Min, Yao Gen-Dong

机构信息

CT Scan Room, Han Dan Central Hospital, Han Dan, China.

出版信息

J Cancer Res Ther. 2016 Jan-Mar;12(1):259-66. doi: 10.4103/0973-1482.155978.

Abstract

BACKGROUND

The objective of the current meta.analysis was to assess the arterial spin labeling. (ASL) perfusion imaging measurement of cerebral blood flow. (CBF) in patients with brain tumors, and assessing preoperative tumor grade in brain.

MATERIALS AND METHODS

PubMed, Web of Science, Embase, China BioMedicine (CBM), CINAHL, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases were chosen to evaluate the associations between ASL and brain cancer. Two reviewers separately evaluated the quality of the included trials. Standardized mean difference (SMD) at 95% confidence interval (95% CI) was also calculated.

RESULTS

Finally, 475 patients were enrolled into this meta-analysis from 12 eligible studies and were selected for statistical analysis. Results showed that relative tumor blood flow (rTBF) and relative cerebral blood flow (rCBF) in high-grade brain cancer patients were faster than those in low-grade brain cancer patients. Subgroup analysis stratified by country implied that ASL may be the main prediction of increased rTBF in high-grade brain cancer patients among USA, Korea and China; and rCBF was faster in high-grade brain cancer using ASL in USA and China. Further reference by tissue-stratified analysis revealed a positive association of rTBF with high-grade brain cancer by utilization of ASL in all the experimental subgroups, while rCBF was only correlated in white subgroups.

CONCLUSION

These results showed that rTBF and rCBF were faster in high-grade brain cancer patients, suggesting that ASL may provide suitable measurement for the differential diagnosis of tumor grade in brain.

摘要

背景

本荟萃分析的目的是评估动脉自旋标记(ASL)灌注成像对脑肿瘤患者脑血流量(CBF)的测量,并评估脑肿瘤的术前分级。

材料与方法

选择PubMed、Web of Science、Embase、中国生物医学文献数据库(CBM)、护理学与健康领域数据库(CINAHL)、考克兰图书馆和中国知网数据库来评估ASL与脑癌之间的关联。两名评价者分别评估纳入试验的质量。还计算了95%置信区间(95%CI)的标准化均数差(SMD)。

结果

最终,从12项符合条件的研究中纳入475例患者进行本荟萃分析并选择进行统计分析。结果显示,高级别脑癌患者的相对肿瘤血流量(rTBF)和相对脑血流量(rCBF)比低级别脑癌患者更快。按国家分层的亚组分析表明,在美国、韩国和中国的高级别脑癌患者中,ASL可能是rTBF增加的主要预测指标;在美国和中国使用ASL的高级别脑癌患者中,rCBF更快。通过组织分层分析进一步参考发现,在所有实验亚组中,使用ASL时rTBF与高级别脑癌呈正相关,而rCBF仅在白人亚组中相关。

结论

这些结果表明,高级别脑癌患者的rTBF和rCBF更快,提示ASL可能为脑肿瘤分级的鉴别诊断提供合适的测量方法。

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