MR灌注成像在脑脓肿与坏死囊变性胶质瘤-第三军医大学学报.DOCVIP

DSC-MR灌注成像在脑脓肿与坏死或囊变性脑肿瘤鉴别诊断中的价值 方维东，罗天友，吕发金、李咏梅、史 斌、吴景全 摘 要目的 探讨动态磁敏感增强（dynamic susceptibility contrast ,DSC）MR灌注成像在脑脓肿与坏死或囊变性脑肿瘤鉴别诊断中的价值。方法 对经手术病理证实的20例包膜期脑脓肿与27例坏死或囊变性脑肿瘤，在术前行常规MRI及MR灌注成像，分析脓壁以及瘤体的MR灌注时间-信号曲线以及CBV伪彩图表现，同时测量并计算其平均最大rrCBV值。结果 脑脓肿的MR灌注时间-信号曲线与坏死囊变性脑肿瘤间存在区别，且16例（16/20）脑脓肿与所有坏死囊变性脑肿瘤的CBV伪彩图表现亦存在不同，同时脓壁的平均最大rrCBV值（2.55±0.92）与瘤体（4.2±1.09）之间的差别具有显著统计学意义P0.01）。结论 DSC-MR灌注成像能反映脑脓肿与坏死或囊变性脑肿瘤的差别，在其术前鉴别诊断中具有重要临床价值。 关键词脑脓肿；脑肿瘤；磁共振成像；灌注加权成像 A study on the Value of PWI in differentiating brain abscess from necrotic or cystic brain tumour Fang Wei-Dong et alAbstract：Objective To explore the value of dynamic susceptibility contrast MR(DSC-MR) perfusion-weighted imaging in differentiation between brain abscess and necrotic or cystic brain tumour. Methods 47 patients with with histologically verified (20 patients with abscess and 27patients with necrotic or cystic brain tumour) were examined before operations using conventional MRI and PWI. The time-signal intensity curves and CBV artificial colour mapping were analysed , the mean maximum rrCBV values of the abscess walls and the bodies of necrotic or cystic brain tumour were measured and calculated. Results The time-signal intensity curves of brain abscess showed differences shape to those of necrotic or cystic brain tumour, also can find differences shape in the CBV artificial colour mapping, the mean maximum rrCBV values in the walls of the abscess (2.55±0.92) was lower than in the bodies of the necrotic or cystic brain tumour (4.32±1.09, p0.001). Conclusion PWI can directly reflect the differences and it is useful in the preoperative differential diagnosis between brain abscess and necrotic or cystic brain tumour, 作者简介：方维东，男，（2、补充籍贯），硕士，主治医师，主要从事神经影像学方面的研究，发表论文8篇。电话：（023E-mail:fwd9707@ 通信作者：罗天友，电话：（023Key words：Brain abscess; brain tumour; magnetic resonance imaging; perfusion weighted imaging 近年来，先后文献报道利用包膜期脑脓肿脓液在DWI呈特征性高信号和弥散受限、ADC值减低，以及在1H-MRS探测到特征性细菌代谢产物峰，可用于部分表现不典型的包膜期脑脓肿与坏死或囊变