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目的探讨3.0 T动态对比增强磁共振(DCE-MRI)渗透性参数鉴别脑胶质瘤真性进展(TP)和假性进展(PP)的价值。方法回顾性分析32例脑胶质瘤术后放化疗后患者的DCE-MRI资料,并测量异常强化区渗透性参数的最大值,即转运常数(K~(trans))、细胞外血管外间隙的体积百分数(v_e)、回流常数(k_(ep))和血浆体积百分数(v_p)。采用分组Mann-Whitney U检验比较脑胶质瘤TP和PP组间各参数,采用ROC曲线分析各参数的阈值、敏感性、特异性和曲线下面积(AUC)。结果 32例患者中TP组(n=18)的K~(trans)和ve的中位值分别为0.34 min-1和0.53,明显高于PP组(n=14)的0.17 min-1和0.39,2组间差异均有统计学意义(Z=3.02,P<0.01;Z=2.03,P<0.05),而k_(ep)值、v_p值组间差异无统计学意义(P>0.05)。ROC曲线分析显示K~(trans)值鉴别诊断脑胶质瘤真性进展的曲线下面积最大(0.815),敏感性和特异性分别为72.2%和85.7%。结论磁共振动态对比增强渗透性参数有助于鉴别脑胶质瘤真性进展和假性进展的诊断,对临床进一步治疗有指导意义。
Objective To investigate the value of 3.0 T dynamic contrast-enhanced magnetic resonance (DCE-MRI) permeability parameters in differentiating true gliomas from false positives (PPs). Methods The DCE-MRI data of 32 patients with glioma after radiotherapy and chemotherapy were retrospectively analyzed. The maximum values of permeability parameters (K trans, extracellular extravascular space) Volume fraction (v_e), reflux constant (k ep), and plasma volume fraction (v_p). Grouping Mann-Whitney U test comparing glioma TP and PP group parameters, using ROC curve analysis of the parameters of the threshold, sensitivity, specificity and area under the curve (AUC). Results The median values of trans and ve of TP group (n = 18) were 0.34 min-1 and 0.53 respectively in 32 patients, which were significantly higher than those of PP group (n = 14) 0.17 min-1 and 0.39 There was significant difference between the two groups (Z = 3.02, P <0.01; Z = 2.03, P <0.05), while there was no significant difference between the k ep values and the vp values (P> 0.05). ROC curve analysis showed that the area under the curve of True transcripts (0.815) was 72.2% and 85.7%, respectively, for the differential diagnosis of gliomas. Conclusion The dynamic contrast enhanced permeability parameters of magnetic resonance can help to distinguish the real progress of gliomas and the diagnosis of false progress, which is of guiding significance for clinical further treatment.