目的: 初步探讨利用体素内不一致运动磁共振成像(IVIM-MRI)检查评价脑转移

瘤的灌注,并与灌注加权成像(PWI)的指标进行相关性评价。

材料与方法:
选取经手术证实的不同类型癌症发生脑转移的患者 30 例行颅脑 MRI 增强

检查。扫􏰀序列包括 IVIM 及 PWI。选取颅内转移病灶共 60 个,应用工作站后 处理软件分别测定瘤体及对侧脑组织 SADC、FADC、FFADC 和 CBF、CBV 值, 并计算出各个参数的相对值(r),即:r 值=(实质病灶值/对侧正常值)×100%。 将瘤体与对侧脑组织的 IVIM 指标进行统计学比较,并将 IVIM 与 PWI 的各参数 进行 Pearson 相关性分析。对 IVIM 和 PWI 的参数进行转移瘤诊断的 ROC 分析。

结果:
1. 转移瘤的与对侧脑组织的 SADC Bi、FADC Bi、FFADC mono 分别为 0.44 ±0.023(×10-3mm2/s)、3.65±0.11(×10-3 mm2/s)、41.67±21.19(×10-3) 和0.22±0.010(×10-3 mm2/s)、2.27±0.12(×10-3 mm2/s)、276.5±8.07(× 10-3),两者间差异有统计学意义(t=4.83,p<0.01);(t=8.36,p<0.05);(t=7.28, p<0.01)。

2.转移瘤的 rFADC 为 5.57±31.66,rCBV 为 2.79±1.27,Person 相关性分 析显示 rFADC 与 rCBV 呈弱相关(r=0.274,P<0.05),而 rFFADC、rSADC 与 rCBF、 rCBV 无明显相关性。

3.FADC mono、FFADC mono、SADC mono、CBF、CBV 的 ROC 曲线分析显示,AUCFADC=0.924(P=0.025);AUCFFADC=0.860(P=0.034);AUCSADC=0.896(P=0.030);AUCCBF=0.849(P=0.035);AUCCBV=0.865(P=0.034)。FADC mono 的 ROC 曲线的 AUC 最大,诊断准确性更高。

结论:
1. IVIM 的参数测量能反映转移瘤的灌注特性。

2.但是由于与 PWI 的技术原理不同,灌注的测量指标之间只具有弱相关性。 

Objective:

Preliminary study of IVIM-MRI is to evaluate the perfusion of brain metastases, and indicate the relevance evaluation with PWI.

Materials and Methods:

Thirty patients with metastatic encephaloma from different types of cancer which is confirmed by surgery underwent MRI enhanced inspections . Obtain IVIM and PWI images. 60 intracranial and 60 contralateral metastatic lesions were selected, and determined the SADCBi, FADCBi, FFADC、FADCand blood flow and blood volume in PWI respectively using the multi ADC Analysis Algorithms and BrainStat GVF coming with the MRI machine. Got the r value, and r= (parenchyma lesions value / the contralateral normal value)*100%. The IVIM and PWI values were compared by Pearson correlation analysis. P<0.05 was considered to indicate a statistically significant difference.

Results:

The SADC value of the brain metastasis tumors is 0.437±0.023(×10-3mm2/s) and the FFADC value of the contralateral brain tissue is 0.223±0.010(×10-3).There is statistically significant difference between them(t=4.83,P<0.01). The FADC value of brain metastasis tumors is 2.27±0.12(×10-3 mm2/s)and the contralateral is 2.27±0.12(×10-3 mm2/s). There is statistically significant difference between them (t=8.36,P<0.05).The FFADC value of the brain metastasis tumors is 441.67±21.19 (×10-3)and the FFADC value of the contralateral brain tissue is 276.5±8.07 ( ×10-3 ) .There is statistically significant difference between them (t=7.28, P<0.01).The rFastADCmono(rFADC)value of the brain metastasis tumors is 5.57±31.66 and the blood volume value is 2.79±1.27. The rFADC and rCBV values have weak correlation(r=0.274,P<0.05, but the rFFADC, rSADC, rCBF and rCBV values have no significant correlation. The FADC, FFADC, SADC, CBF, CBV ROC curve analysis showed that AUCFADC=0.924 (P=0.025), AUCFFADC=0.860 (P=0.034), AUCSADC=0.896 (P=0.030), AUCCBF=0.849(P=0.035)and AUCCBV=0.865(P=0.034).

Conclusion:
1.IVIM parameter measurement can reflect the perfusion characteristics of metastatic tumor.
2.But due to the different from PWI technology principle, it only has a weak correlation between perfusion measurement indicators.