目的:探讨容积转运常数(volume transfer constant,Ktrans )对高级别胶质瘤(high grade glioma,HGG)与脑转移瘤的鉴别诊断价值。方法收集经手术病理证实的 HGG 12例及脑转移瘤27例,所有患者均行 MR动态增强检查(dynamic contrast en-hance MRI,DCE-MRI),对比剂为钆喷酸葡胺,剂量0.1 mmol/kg体重,注射速度3 mL/s。采用盲法读片,测量颅内占位性病变实质区及瘤周水肿区的Ktrans值。使用 SPSS13.0进行统计学分析,对脑转移瘤与 HGG之间 Ktrans差异的比较采用Mann-Whitney U检验,P 0.05),而瘤周水肿区Ktrans值的差异具有统计学意义(P<0.05)。Ktrans以0.03 min-1为阈值时,鉴别诊断脑转移瘤与 HGG的灵敏度75%,特异度70%。结论根据瘤周水肿区域的Ktrans值,可对脑转移瘤与高级别胶质瘤的鉴别提供帮助。
Objective To determine whether volume transfer coefficient (Ktrans )can be used to differentiate high-grade glioma (HGG)and metastasis.Methods Thirty-nine patients with brain tumors (12 HGG,27 metastases)underwent dynamic contrast en-hanced MR imaging before surgical resection or stereotactic biopsy.Images were acquired with a three-dimensional (3D)fast gradi-ent echo sequence.Gadolinium-based contrast agent was injected intravenously with dosage of 0.1 mmol/kg bodyweight at a rate of 3.0 mL/s.Ktrans and Ve were calculated from the DCE MRI data.The results of Ktrans and Ve were compared between the 2 types of tumors.Receiver operating characteristic curve analysis was performed for each of the variables in differentiation cerebral metastasis from HGG.Results The Ktrans values in the parenchyma of HGG and metastases were 0.10 (0.11,0.71)min-1 and 0.21 (0.05, 0.77)min-1 ,respectively.The difference was not statistically significant (P>0.05).The Ktrans values in the peritumoral region of