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目的应用DWI及PWI的各项相关参数对低级别胶质瘤、高级别胶质瘤、淋巴瘤及转移瘤的生长趋势,血管生成及瘤周侵犯的情况进行评价。方法应用DWI及PWI检查脑内占位病例54例。分别以肿瘤瘤体实质、肿瘤外水肿内1 cm、肿瘤外水肿内2 cm、水肿外1 cm、水肿区域以外1 cm的白质区域为感兴趣区,以正常脑白质为对照感兴趣区,分别测量各个感兴趣区的ADC、rCBV、rCBF值。将感兴趣区与对照感兴趣区的量化指标进行比值计算,得到相对ADC、相对r CBV、相对rCBF值。并对各项参数进行统计分析。结果不同肿瘤实质ADC值之间(P=0.003)以及瘤周水肿内2 cm处ADC值之间差异具有统计学意义(P=0.012)。HGG瘤体、水肿内1 cm处、水肿内2 cm处的rCBV、rrCBV、rCBF及rrCBF值均高于其他类型肿瘤,差异均存在统计学意义(P<0.05)。结论通过DWI及PWI对低级别胶质瘤、高级别胶质瘤、淋巴瘤及转移瘤这四种类型的瘤体、瘤周水肿区、水肿外区域的ADC、rCBV、rCBF值及其相对值的分析,能提高肿瘤的诊断准确率并指导临床手术切除范围。
Objective To evaluate the growth trend, angiogenesis and peritumorous invasion of low grade gliomas, high grade gliomas, lymphomas and metastases by using the related parameters of DWI and PWI. Methods The application of DWI and PWI in the examination of 54 cases of brain space. Respectively, the tumor substance in vivo, within 1 cm of extra-tumor edema, within 2 cm of edema, within 1 cm of edema, 1 cm beyond the edema area of white matter area of interest, normal white matter as the control area of interest, respectively ADC, rCBV, rCBF values were measured for each region of interest. The ratio between the region of interest and that of the control region of interest was calculated and the relative ADC, relative r CBV, and relative rCBF values were obtained. And the parameters of statistical analysis. Results There was a significant difference (P = 0.012) between ADC values of different tumor parenchyma (P = 0.003) and ADC value of 2 cm within peritumoral edema. The values of rCBV, rrCBV, rCBF and rrCBF in HGG tumor, 1 cm in edema and 2 cm in edema were higher than those in other types of tumors (P <0.05). Conclusions The ADC, rCBV, rCBF values and relative values of DWI and PWI in four types of low grade gliomas, high grade gliomas, lymphoma and metastases, peritumoral edema area and edema area The analysis can improve the accuracy of tumor diagnosis and guide the scope of clinical resection.