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目的探讨弥散张量成像(DTI)相对各向异性(rFA)值和相对表观系数(rADC)值在评价脑胶质瘤病理等级中的应用价值。方法对27例经手术及组织病理学证实的胶质瘤患者,术前行常规MRI、DTI检查。在FA图上,感兴趣区分别设定在瘤体实质部(FA1)、瘤体边缘(FA2),周围水肿(FA3),以及对侧半球皮质脊髓束(FAc),测量出FA1、FA2、FA3及FAc值;在相同层面ADC图上同位置,测量出ADC1、ADC2、ADC3及ADCc值,计算出相对FA值(rFA1-3)和相对ADC值(rADC1-3),rFA、rADC与胶质瘤的病理级别之间关系进行统计学处理。结果27例胶质瘤患者,其中低级别胶质瘤(WHOgradeⅠ~Ⅱ)14例,高级别胶质瘤(WHOgrade Ⅲ~Ⅳ)13例。肿瘤实质部rFA1值与肿瘤级别无显著相关性(r=0.328,P>0.05),肿瘤边缘的rFA2值高级别胶质瘤高于低级别(t=2.453,P<0.05),水肿区高级别胶质瘤的rFA3值低于低级别(t=2.318,P<0.05);肿瘤实质部rADC1值、肿瘤边缘rADC2值与肿瘤恶性程度存在显著负相关(r分别为-0.393、-0.404,P值均<0.05),水肿区高级别胶质瘤的rADC3值高于低级别(t=4.715,P<0.01)。结论胶质瘤边缘的rFA2值、水肿区rFA3值及胶质瘤瘤体部、边缘、水肿区的rADC值在胶质瘤的术前病理分级诊断中具有参考价值。
Objective To investigate the value of relative anisotropy (rFA) and relative apparent coefficient (rADC) of diffusion tensor imaging (DTI) in the evaluation of glioma pathological grade. Methods Twenty-seven patients with glioma confirmed by operation and histopathology were examined by conventional MRI and DTI before operation. In FA maps, the regions of interest were set at FA1, FA2, FA3, and contralateral cortical spinal cords (FAc), FA1, FA2, FA3 and FAc values; ADC1, ADC2, ADC3 and ADCc values were measured at the same level on the same ADC map to calculate relative FA values (rFA1-3) and relative ADC values (rADC1-3), rFA, rADC and glue The relationship between the pathological grade of the tumor was statistically analyzed. Results Twenty - seven patients with gliomas, including 14 patients with low grade gliomas (WHOgrade Ⅰ ~ Ⅱ) and 13 patients with high grade gliomas (WHO grade Ⅲ ~ Ⅳ). There was no significant correlation between the rFA1 value and the tumor grade (r = 0.328, P> 0.05). The rFA2 high-grade glioma at the margin of the tumor was higher than the low grade (t = 2.453, P <0.05) The value of rFA3 in glioma was lower than that in low grade (t = 2.318, P <0.05). There was a significant negative correlation between rADC1 and rADC2 in tumor parenchyma (r = -0.393, -0.404, P = (All P <0.05). The rADC3 value of high grade gliomas in edema area was higher than that of low grade (t = 4.715, P <0.01). Conclusion The rFA2 value at the edge of glioma, the rFA3 value in edema area and the rADC value in the body, margins and edema area of glioma have a reference value in the preoperative pathological grading of glioma.