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脑肿瘤周围白质中与肿瘤相关的灌注变化:3T动态磁共振成像的药效学分析

Tumor-related Perfusion Changes in White Matter Adjacent to Brain Tumors: Pharmacodynamic Analysis of Dynamic 3T Magnetic Resonance Imaging.

作者信息

Tupý Radek, Mírka Hynek, Mraček Jan, Přibáň Vladimír, Hes Ondřej, Vokurka Samuel, Ferda Jiří

机构信息

Department of Medical Imaging, Charles University Hospital in Pilsen, Pilsen, Czech Republic

Department of Medical Imaging, Charles University Hospital in Pilsen, Pilsen, Czech Republic.

出版信息

Anticancer Res. 2018 Jul;38(7):4149-4152. doi: 10.21873/anticanres.12707.

Abstract

BACKGROUND/AIM: To verify perfusion differences in white matter adjacent to glioblastomas and metastatic tumors in dynamic contrast-enhanced (DCE) 3T-magnetic resonance imaging (MRI) using gradient echo (GRE) T1 techniques.

MATERIALS AND METHODS

A retrospective comparative study was carried out on adults with glioblastoma (n=67) and brain metastases (n=31). In each patient, conventional 3T-MRI and DCE-MRI with 25 acquisitions of GRE-T1 were performed. The initial area under the contrast-uptake curve (iAUC) and transfer constant (K) in peritumoral regions of the white matter were evaluated using T1 pharmacodynamic modeling software.

RESULTS

Statistically significantly higher relative iAUC (p<0.001) and K (p<0.01) values were recorded for peritumoral white matter near glioblastomas compared to that near metastases: 2.29 (SD=1.11) and 2.12 (SD=1.05) vs. 0.96 (SD=0.31) and 1.18 (SD=0.35), respectively.

CONCLUSION

In comparison to K, the iAUC obtained by DCE-MRI is more suitable for assessing glioblastomas because it better reflects pharmacokinetic peritumoral changes. Increased iAUC in white matter near to tumor generally indicates glioblastoma, however, a low level does not exclude it.

摘要

背景/目的:在动态对比增强(DCE)3T磁共振成像(MRI)中,使用梯度回波(GRE)T1技术验证胶质母细胞瘤和转移瘤周围白质的灌注差异。

材料与方法

对患有胶质母细胞瘤(n = 67)和脑转移瘤(n = 31)的成人进行回顾性比较研究。对每位患者进行常规3T-MRI和DCE-MRI检查,其中DCE-MRI进行25次GRE-T1采集。使用T1药效学建模软件评估白质瘤周区域的初始对比剂摄取曲线下面积(iAUC)和转移常数(K)。

结果

与转移瘤周围的白质相比,胶质母细胞瘤周围白质的相对iAUC(p < 0.001)和K(p < 0.01)值在统计学上显著更高:分别为2.29(标准差 = 1.11)和2.12(标准差 = 1.05),而转移瘤周围白质的相对iAUC和K值分别为0.96(标准差 = 0.31)和1.18(标准差 = 0.35)。

结论

与K相比,DCE-MRI获得的iAUC更适合评估胶质母细胞瘤,因为它能更好地反映瘤周药代动力学变化。肿瘤周围白质中iAUC升高通常提示胶质母细胞瘤,但iAUC水平低并不排除胶质母细胞瘤的存在。

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