摘要
目的 探究磁共振(MRI)多模态成像对脑胶质瘤术后放化疗疗效的评估价值.方法 选取2019年10月-2021年10月在南方医院赣州医院进行手术及放化疗治疗的脑胶质瘤患者90例,所有受试者均于放化疗前及随访6个月后采用MRI多模态成像检查[磁共振头颅平扫加增强+灌注加权成像(PWI)+动脉自旋标记灌注技术(ASL)+磁共振波谱分析(MRS)],比较化疗前后MRI多模态成像各指标[局部脑血容量(rCBV)、脑血流量(rCBF),胆碱/肌酸比值(Cho/Cr)、Cho/N-乙酰天门冬氨酸比值(Cho/NAA)、相对脑血容量(CBV)]变化情况,依据手术及穿刺活检病理评估患者预后,并比较预后良好与预后不良的MRI多模态成像指标,受试者特征曲线(ROC)分析MRI多模态成像指标预测颅内恶性肿瘤术后放化疗患者预后的价值.结果 化疗后MRI多模态成像指标rCBV、rCBF、Cho/Cr、Cho/NAA、ADC值、CBV值较化疗前均明显下降(P<0.05);预后不良组MRI多模态成像指标rCBV、rCBF、Cho/Cr、Cho/NAA、CBV、ADC均明显较预后良好组高(P<0.05);ROC曲线分析显示,CBV、ADC、Cho/Cr、Cho/NAA预测颅内恶性肿瘤术后放化疗患者预后的AUC分别为0.842、0.839、0.815、0.764.结论 MRI多模态成像检查评估脑胶质瘤术后放化疗患者放疗效果良好,具有较高诊断效能,其MRI多模态成像指标可有效预测患者预后,可在临床推广应用.
Objective To explore the value of multimodal magnetic resonance imaging(MRI)in the evaluation of postoperative chemoradiotherapy for glioma.Methods From October 2019 to October 2021,90 patients with glioma underwent surgery and radiotherapy and chemotherapy in our hospital were selected.All subjects were examined by MRI multimodal imaging[magnetic resonance skull scan plus enhancement+perfusion weighted imaging(PWI)+Arterial Spin Labeling Perfusion MRI(ASL)+Magnetic resonance spectroscopy(MRS)]before chemoradiotherapy and 6 months after follow-up.The changes of various indexes of MRI multimode imaging[local cerebral blood volume(rCBV),cerebral blood flow(rCBF),choline/creatine ratio(Cho/Cr),Cho/N-acetylaspartate ratio(Cho/NAA),relative cerebral blood volume(CBV)before and after chemotherapy were compared.The prognosis of patients was assessed according to the pathology of surgery and puncture biopsy,and MRI multimodal imaging indexes with good prognosis and poor prognosis were compared.Receiver characteristic curve(ROC)was used to analyze the prognostic value of MRI multimodal imaging indexes in predicting the prognosis of patients with postoperative radiotherapy and chemotherapy for intracranial malignant tumor.Resul ts After chemotherapy,MRI multimodal imaging indexes rCBV,rCBF,Cho/Cr,Cho/NAA,ADC and CBV values were significantly decreased compared with those before chemotherapy(P<0.05).MRI multimodal imaging indexes rCBV,rCBF,Cho/Cr,Cho/NAA,CBV and ADC in poor prognosis group were significantly higher than those in good prognosis group(P<0.05).ROC curve analysis showed that the AUC of CBV,ADC,Cho/Cr and Cho/NAA in predicting the prognosis of patients with intracranial malignant tumor after radiotherapy and chemotherapy were 0.842.0.839,0.815 and 0.764,respectively.Conc lus ion MRI multimodal imaging has a good effect on the evaluation of postoperative radiotherapy and chemotherapy in patients with glioma,and has a high diagnostic efficiency.The MRI multimodal imaging index can effectively predict the prognosis of patients,and can be popularized in clinical application.
作者
梁景红
黄晓尧
陈仕泽
王晓春
Liang Jinghong;Huang Xiaoyao;Chen Shize;Wang Xiaochun(Department of medical imaging,Ganzhou Hospital of Nanfang Hospital(Ganzhou people's Hospital),Ganzhou,Jiangxi 34100o,china)
出处
《首都食品与医药》
2022年第19期105-108,共4页
Capital Food Medicine
关键词
磁共振多模态成像
脑胶质瘤
放化疗
Magnetic resonance mulimodal imaging
Glioma of the brain
Radiation and chemotherapy
