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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转移瘤和高级胶质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例坏死或囊变性脑转移瘤和高级胶质瘤患者,在术前行常规MRI及DSC-MR灌注成像,分析脓肿壁以及瘤体的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-信号曲线与坏死或囊变性脑转移瘤和高级胶质瘤间存在区别,且16例(16/20)脑脓肿与所有27例坏死或囊变性脑转移瘤和高级胶质瘤的CBV伪彩图表现亦存在不同,同时脓肿壁的最大rrCBV值(2.55±0.92)与瘤体(4.32±1.09)比较差异有统计学意义(P<0.01)。结论DSC-MR灌注成像能反映脑脓肿与坏死或囊变性脑转移瘤和高级胶质瘤的差别,在其术前鉴别诊断中具有重要的临床价值。
Objective To investigate the value of dynamic susceptibility contrast (MR) MR perfusion imaging in differentiating brain abscess from necrotic or cystic brain metastases and gliomas. Methods Twenty patients with enucleated brain abscess and 27 patients with necrotic or cystic brain metastases and advanced gliomas confirmed by surgery and pathology were examined with routine MRI and DSC-MR perfusion imaging before surgery to analyze the abscess wall and tumor MR perfusion time - signal curve and CBV pseudo-color image performance, while measuring and calculating the average maximum rrCBV value. Results MR perfusion time-signal curves of brain abscess differed from those of necrotic or cystic brain metastases and advanced gliomas, and 16 (16/20) brain abscesses correlated with all 27 patients with necrotic or cystic brain metastases and advanced There were also differences in CBV pseudo-color images of gliomas. The maximum rrCBV value of the abscess wall (2.55 ± 0.92) was significantly different from that of the tumor (4.32 ± 1.09) (P <0.01). Conclusion DSC-MR perfusion imaging can reflect the difference between brain abscess and necrotic or cystic brain metastases and high grade gliomas, and has important clinical value in its differential diagnosis.