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目的:通过与高分辨率三维(3D)增强T1WI上肿瘤容积的比较,评价二维(2D)增强T1WI上肿瘤容积测量在脑胶质母细胞瘤疗效评估中的价值。方法:36例成人脑胶质母细胞瘤患者的72次MRI扫描,采用3.0T MRI进行头颅常规MRI平扫和2D(层厚5 mm)及高分辨率3D(1 mm各向同性体素)增强T1WI,在2D及高分辨率3D增强T1WI上分别测量肿瘤容积,采用Wilcoxon秩和检验比较二者间差异;并对同一患者测量结果进行配对,根据肿瘤大小的变化,把肿瘤治疗疗效分为完全缓解、部分缓解、肿瘤稳定和肿瘤进展,采用Kappa加权检验评价2种方法的一致性。结果:2D及高分辨率3D增强T1WI上的肿瘤容积差异无统计学意义(Z=1.20,P=0.23),有高度相关性(r=0.95,P<0.01)。当根据2种方法测得的肿瘤容积的百分比变化将肿瘤反应分为完全缓解、部分缓解、肿瘤稳定和肿瘤进展时,2种方法的Kappa系数为0.80,总体一致率为86%。结论:在评价脑胶质母细胞瘤治疗疗效中,2D增强T1WI上肿瘤容积与高分辨率3D增强T1WI上肿瘤容积具有可比性,可作为后者的实用替代方法。
OBJECTIVE: To evaluate the value of tumor volume measurements on two-dimensional (2D) enhanced T1WI in the evaluation of the efficacy of brain glioblastoma by comparison with the high-resolution three-dimensional (3D) enhanced T1WI tumor volume. METHODS: Thirty-six MRI scans of 36 patients with adult glioblastoma were performed with 3.0T MRI for normal skull MRI and 2D (thickness 5 mm) and high resolution 3D (1 mm isotropic voxels) The T1WI was enhanced and the volume of tumor was measured on 2D and high resolution 3D enhanced T1WI respectively. The Wilcoxon rank sum test was used to compare the differences between the two. The paired results of the same patient were also analyzed. According to the changes of tumor size, Complete remission, partial remission, tumor stabilization and tumor progression. The consistency of the two methods was evaluated by Kappa-weighted test. Results: There was no significant difference in tumor volume between 2D and high resolution 3D enhanced T1WI (Z = 1.20, P = 0.23), which was highly correlated (r = 0.95, P <0.01). The Kappa coefficient of the two methods was 0.80 and the overall concordance rate was 86% when the tumor response was divided into complete remission, partial remission, tumor stabilization and tumor progression as a function of the percent change in tumor volume measured by the two methods. CONCLUSIONS: In evaluating the efficacy of treatment of brain glioblastoma, the tumor volume on the 2D-enhanced T1WI is comparable to the tumor volume on the high-resolution 3D-enhanced T1WI and may serve as a practical alternative to the latter.