Medical Imaging Department, PuEr People's Hospital, Yunnan PuEr, China.
The Radiological Department of the First People's Hospital of Urumqi, Urumqi, Xinjiang, China.
World Neurosurg. 2021 May;149:325-332. doi: 10.1016/j.wneu.2020.09.113. Epub 2020 Sep 28.
We used dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) technology and its perfusion parameters to diagnose central glioma high-grade glioma (HGG), primary central nervous system glioma low-grade glioma (LGG), brain metastases, and meningioma and make differential diagnoses.
Forty-one cases of brain tumors (8 cases of LGG, 17 cases of HGG, 5 cases of "primary central nervous system lymphoma" [PCNSL], 6 cases of brain metastases, and 5 cases of meningiomas) were subjected to routine and DCE-MRI scans. The DCE-MRI quantitative parameters of the tumor parenchymal area and peripheral enema area of each tumor were measured and recorded as t-Ktrans value, t-Ve value, t-Vp value, t-Kep value and p-Ktrans value, p-Ve value, p-Vp value, and p-Kep value.
Compared with other tumor types, LGG showed lower t-Ktrans value (P < 0.01, sensitivity = 89%, specificity = 99%) and low t-Ve value (P < 0.01, sensitivity = 94%, specificity = 100%); PCNSL showed a high t-Ve value (P < 0.01, sensitivity = 100%, specificity = 88%), but other perfusion parameters overlap more obviously with other tumors. Compared with LGG, the difference between t-Ktrans value, t-Ve value, and t-Kep value is statistically significant. Among them, t-Ktrans value distinguishes the highest sensitivity and specificity (when t-Ktrans value = when 0.154 is the cutoff value, the area under the curve is 1.000, P = 0.000, specificity = 100%, sensitivity = 94.1%); compared with PCNSL, the difference of t-Ve value between HGG and PCNSL is statistically significant, t-Ve of PCNSL. The value is slightly higher, and its specificity and sensitivity are not high.
DCE-MRI can distinguish HGG and LGG more accurately, of which t-Ktrans value has higher specificity and sensitivity, although the difference of t-Ve value between PCNSL and HGG is statistically significant but the sensitivity and specificity are not high; the p-Ktrans value and p-Kep value of metastatic tumors are lower than HGG and have higher specificity, but meningiomas and HGG and PCNSL, meningiomas and metastases are not accurate identification.
我们使用动态对比增强磁共振成像（DCE-MRI）技术及其灌注参数来诊断中枢神经胶质瘤高级别胶质瘤（HGG）、原发性中枢神经系统神经胶质瘤低级别胶质瘤（LGG）、脑转移瘤和脑膜瘤，并进行鉴别诊断。
对 41 例脑肿瘤患者（8 例 LGG、17 例 HGG、5 例“原发性中枢神经系统淋巴瘤”[PCNSL]、6 例脑转移瘤和 5 例脑膜瘤）进行常规和 DCE-MRI 扫描。测量并记录每个肿瘤的肿瘤实质区和外周灌肠区的 DCE-MRI 定量参数 t-Ktrans 值、t-Ve 值、t-Vp 值、t-Kep 值和 p-Ktrans 值、p-Ve 值、p-Vp 值和 p-Kep 值。
与其他肿瘤类型相比，LGG 的 t-Ktrans 值较低（P < 0.01，灵敏度= 89%，特异性= 99%），t-Ve 值较低（P < 0.01，灵敏度= 94%，特异性= 100%）；PCNSL 的 t-Ve 值较高（P < 0.01，灵敏度= 100%，特异性= 88%），但其他灌注参数与其他肿瘤重叠更为明显。与 LGG 相比，t-Ktrans 值、t-Ve 值和 t-Kep 值的差异具有统计学意义。其中，t-Ktrans 值区分的灵敏度和特异性最高（当 t-Ktrans 值= 0.154 时，曲线下面积为 1.000，P = 0.000，特异性= 100%，灵敏度= 94.1%）；与 PCNSL 相比，HGG 和 PCNSL 之间的 t-Ve 值差异具有统计学意义，PCNSL 的 t-Ve 值稍高，特异性和灵敏度不高。
DCE-MRI 能更准确地区分 HGG 和 LGG，其中 t-Ktrans 值具有更高的特异性和灵敏度，尽管 PCNSL 和 HGG 之间的 t-Ve 值差异具有统计学意义，但灵敏度和特异性不高；转移瘤的 p-Ktrans 值和 p-Kep 值低于 HGG，特异性较高，但脑膜瘤与 HGG 和 PCNSL、脑膜瘤与转移瘤的鉴别不准确。
