体素内不相干运动扩散加权成像在脑膜瘤中的初步临床研究
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摘要
目的探讨体素内不相干运动扩散加权磁共振成像(IVIM-MRI)单、双指数模型在脑膜瘤中的应用价值。方法纳入20例经手术切除及病理结果证实为脑膜瘤的病例,均于术前行常规MRI及IVIM-MRI扫描,测量肿瘤实质区及正常脑白质区单指数模型下表观扩散系数ADC值和双指数模型下纯扩散系数D值、灌注分数f值、灌注系数D*值,分析脑膜瘤的IVIM-MRI成像特点。结果单指数模型中,肿瘤实质区ADC值较正常脑白质ADC值低,但两者差异无统计学意义(t=0.514,P>0.05);双指数模型中,肿瘤实质区与正常脑白质区D值差异有统计学意义(t=3.043,P<0.01);而D*值和f值差异无统计学意义(t=1.274、0.220,均P>0.05)。4种不同病理类型脑膜瘤比较,单指数模型下ADC值及双指数模型下D、f值均有显著差异(F=5.232、5.674、14.058,均P<0.01)。结论 IVIM-MRI能够准确描述脑膜瘤扩散信息,并同时获得脑膜瘤灌注信息,可考虑作为一种无创性脑肿瘤灌注检查方法。
Objective To evaluate the application value of the mono-exponential model and bi-exponential model of intravoxel incoherent motion diffusion-weighted MRI(IVIM-MRI) in meningiomas. Methods Twenty meningioma patients confirmed by surgical pathology were brought into this study, and received routine MRI and IVIM-MRI scan. The apparent diffusion coefficient(ADC) of mono-exponential model and the diffusion coefficient( D), pseudo perfusion coefficient( D*) and the perfusion fraction( f) of bi-exponential model were measured both in tumor and normal white matter(NWM) areas, then the IVIM-MRI feature of meningioma was analyzed. Results In mono-exponential model, ADC value was lower in the tumor area than in NWM area, but the difference was not statistically significant(t = 0.514, P > 0.05). In bi-exponential model, the difference in D value was statistically significant between tumor and NWM areas(t=3.043, P < 0.01), while there was no significant difference in D* and f values between tumor and NWM areas(t =1.274, 0.220, P > 0.05). Otherwise, there were significant differences in ADC, D, f values between the four different pathological subtypes of meningiomas(F = 5.232, 5.674, 14.058, P < 0.01). Conclusion IVIM-MRI can get the accurate perfusion and diffusion informations of meningiomas, and can be considered as a noninvasive perfusion method for brain tumors.
Objective To evaluate the application value of the mono-exponential model and bi-exponential model of intravoxel incoherent motion diffusion-weighted MRI(IVIM-MRI) in meningiomas. Methods Twenty meningioma patients confirmed by surgical pathology were brought into this study, and received routine MRI and IVIM-MRI scan. The apparent diffusion coefficient(ADC) of mono-exponential model and the diffusion coefficient( D), pseudo perfusion coefficient( D*) and the perfusion fraction( f) of bi-exponential model were measured both in tumor and normal white matter(NWM) areas, then the IVIM-MRI feature of meningioma was analyzed. Results In mono-exponential model, ADC value was lower in the tumor area than in NWM area, but the difference was not statistically significant(t = 0.514, P > 0.05). In bi-exponential model, the difference in D value was statistically significant between tumor and NWM areas(t=3.043, P < 0.01), while there was no significant difference in D* and f values between tumor and NWM areas(t =1.274, 0.220, P > 0.05). Otherwise, there were significant differences in ADC, D, f values between the four different pathological subtypes of meningiomas(F = 5.232, 5.674, 14.058, P < 0.01). Conclusion IVIM-MRI can get the accurate perfusion and diffusion informations of meningiomas, and can be considered as a noninvasive perfusion method for brain tumors.
引文
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[13]YIPING L,KAWAI S,JIANBO W,et al.Evaluation parameters between intra-voxel incoherent motion and diffusion-weighted imaging in grading and differentiating histological subtypes of meningioma:A prospective pilot study[J].J Neurol Sci,2017,372:60-69.
[14]SUROV A,GOTTSCHLING S,MAWRIN C,et al.Diffusion-weighted imaging in meningioma:prediction of tumor grade and association with histopathological parameters[J].Transl Oncol,2015,8(6):517-523.
[2]WANG R P,XU L,ZHOU S,et al.Comments on“IVIMdiffusion-MRI for the differentiation of solid benign and malign hypervascular liver lesions”[J].Eur J Radiol,2016,85(12):2295.
[3]LIANG L,CHEN W B,CHAN K W,et al.Using intravoxel incoherent motion MR imaging to study the renal pathophysiological process of contrast-induced acute kidney injury in rats:Comparison with conventional DWI and arterial spin labelling[J].Eur Radiol,2016,26(6):1597-1605.
[4]MA C,LIU L,LI Y,et al.Intravoxel incoherent motion MRI of the healthy pancreas:Mono-exponential and biexponential apparent diffusion parameters of the normal head,body and tail[J].J Magn Reson Imaging,2015,41(5):1236-1241.
[5]LIU C,LIANG C,LIU Z,et al.Intravoxel incoherent motion(IVIM)in evaluation of breast lesions:Comparison with conventional DWI[J].Eur J Radiol,2013,82(12):e782-e789.
[6]RICHES S F,HAWTIN K,CHARLES-EDWAR E M,et al.Diffusion-weighted imaging of the prostate and rectal wall:comparison of biexponential and monoexponential modeled diffusion and associated perfusion coefficients[J].NMR Biomed,2009,22(3):318-325.
[7]DALE B M,BRAITHWAITE A C,Boll D T,et al.Field strength and diffusion encoding technique affect the apparent diffusion coefficient measurements in diffusionweighted imaging of the abdomen[J].Invest Radiol,2010,45(2):104-108.
[8]NIU J,LI W,WANG H,et al.Intravoxel incoherent motion diffusion-weighted imaging of bone marrow in patients with acute myeloid leukemia:a pilot study of prognostic value[J].J Magn Reson Imaging,2017,PMID:28211619.
[9]HAUSER T,ESSIG M,JENSEN A,et al.Prediction of treatment response in head and neck carcinomas using IVIM-DWI:Evaluation of lymph node metastasis[J].Eur J Radiol,2014,83(5):783-787.
[10]钟帅,姚鑫,张学斌,等.29例儿童脑膜瘤的临床病理分析[J].中国微侵袭神经外科杂志,2016,21(10):436-439.
[11]李玉超,王光彬,刘强,等.体素内不相干运动扩散加权成像在良性脑膜瘤中的初步研究[J].医学影像学杂志,2014,24(3):461-464,473.
[12]LE BIHAN D,BRETON E,LALLEMAND D,et al.MR imaging of intravoxel incoherent motions:application to diffusion and perfusion in neurologic disorders[J].Radiology,1986,161(2):401-407.
[13]YIPING L,KAWAI S,JIANBO W,et al.Evaluation parameters between intra-voxel incoherent motion and diffusion-weighted imaging in grading and differentiating histological subtypes of meningioma:A prospective pilot study[J].J Neurol Sci,2017,372:60-69.
[14]SUROV A,GOTTSCHLING S,MAWRIN C,et al.Diffusion-weighted imaging in meningioma:prediction of tumor grade and association with histopathological parameters[J].Transl Oncol,2015,8(6):517-523.