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对比增强磁共振成像在鉴别脑胶质瘤与脑转移瘤中的疗效评估及其与患者神经功能的相关性探索

Efficacy evaluation of contrast-enhanced magnetic resonance imaging in differentiating glioma from metastatic tumor of the brain and exploration of its association with patients' neurological function.

作者信息

Shi Zhuo, Jiang Jiuming, Xie Lizhi, Zhao Xinming

机构信息

Department of Imaging Diagnosis, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

GE Healthcare, MR Research China, Beijing, China.

出版信息

Front Behav Neurosci. 2022 Sep 6;16:957795. doi: 10.3389/fnbeh.2022.957795. eCollection 2022.

Abstract

OBJECTIVE

To determine the efficacy of contrast-enhanced MRI in differentiating glioma (GL) from the metastatic tumor of the brain (MTB) and its association with patients' neurological function.

METHODS

A retrospective analysis was conducted on 49 cases of pathologically confirmed GL and 42 cases of MTB admitted between April 2019 and January 2022. All patients were examined by a set of MRI sequences that included T1WI, T2WI, FLAIR, and DWI. The values of fractional anisotropy (FA), apparent diffusion coefficient (ADC), and operation coefficient (K) were calculated by taking the tumor parenchyma area, cystic area, and peritumor edema area as the regions of interest (ROIs). And according to the Mini-mental state examination (MMSE) results, the contrast-enhanced MRI with patients' neurological dysfunction was observed.

RESULTS

The clinical symptoms and MRI findings of MTB and GL were basically the same, mainly showing neurological symptoms. The tumor parenchyma area and cystic area were mainly located in the tumor periphery and tumor central area, respectively, while the peritumor edema area was widely distributed, showing an irregular patchy edema zone. Contrast-enhanced scans suggested an obvious enhancement in the tumor parenchymal area, presenting with nodular and annular enhancement, but no enhancement in the tumor cystic and peritumor edema areas. There was no difference between GL and MTB in FA values of tumor cystic area and peritumor edema area ( > 0.05), but the FA value of the parenchyma area of GL was higher ( < 0.05). Besides, GL and MTB showed no difference in ADC and K values ( > 0.05), while the former presented lower ADC values and higher K values of the peritumor edema area than the latter ( < 0.05). In patients with GL and MTB, the FA and K values of all ROIs in those with neurological dysfunction were higher compared with those without neurological dysfunction, while the ADC values were lower ( < 0.05).

CONCLUSION

Contrast-enhanced MRI of peritumor edema area can effectively distinguish GL from MTB, and improve the accuracy of early clinical screening, thus providing more reliable life security for patients.

摘要

目的

确定对比增强磁共振成像(MRI)在鉴别胶质瘤(GL)与脑转移瘤(MTB)中的效能及其与患者神经功能的相关性。

方法

对2019年4月至2022年1月收治的49例经病理证实的GL患者和42例MTB患者进行回顾性分析。所有患者均接受了包括T1WI、T2WI、FLAIR和DWI在内的一组MRI序列检查。以肿瘤实质区、囊性区和瘤周水肿区为感兴趣区(ROIs),计算各向异性分数(FA)、表观扩散系数(ADC)和运算系数(K)值。并根据简易精神状态检查表(MMSE)结果,观察对比增强MRI与患者神经功能障碍的关系。

结果

MTB和GL的临床症状及MRI表现基本相同,主要表现为神经症状。肿瘤实质区和囊性区分别主要位于肿瘤周边和肿瘤中心区,而瘤周水肿区分布广泛,呈不规则片状水肿带。对比增强扫描显示肿瘤实质区明显强化,呈结节状和环状强化,而肿瘤囊性区和瘤周水肿区无强化。GL和MTB的肿瘤囊性区和瘤周水肿区的FA值无差异(>0.05),但GL实质区的FA值较高(<0.05)。此外,GL和MTB的ADC和K值无差异(>0.05),但前者瘤周水肿区的ADC值低于后者,K值高于后者(<0.05)。在GL和MTB患者中,有神经功能障碍者所有ROIs的FA和K值均高于无神经功能障碍者,而ADC值较低(<0.05)。

结论

瘤周水肿区的对比增强MRI能有效鉴别GL与MTB,提高临床早期筛查的准确性,从而为患者提供更可靠的生命保障。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e9e/9486092/06e60ba50bb9/fnbeh-16-957795-g001.jpg

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