党佩;王立东;黄雪莹;刘静静;吕瑞瑞;杨治花;王晓东;

• 1:宁夏医科大学总医院放射科
• 2:银川市中医医院放射科
• 3:西安市胸科医院放射科
• 4:宁夏医科大学临床医学院

摘要(Abstract)：

目的 探讨扩散峰度成像(diffusional kurtosis imaging,DKI)技术在鉴别脑胶质瘤复发与假性进展中的临床应用价值。材料与方法 回顾性分析宁夏医科大学总医院2018年10月至2020年12月间40例术后行放、化疗并行DKI序列扫描的脑胶质瘤患者资料。通过二次手术病理或经增强MRI扫描随访>6个月，分复发组(24例)与假性进展组(16例)。采用独立样本t检验或Mann-Whitney U检验，受试者工作特征曲线比较两组患者增强病灶和瘤周水肿中DKI参数值：平均扩散峰度(mean kurtosis,MK)、平均扩散系数(mean diffusivity,MD)、径向扩散峰度(radial kurtosis,RK)、轴向扩散峰度、各向异性分数。以患者无进展生存期(gression free survival,PFS)作为事件的观察终点，Cox比例风险模型用于多因素分析。结果 复发组较假性进展组增强病灶的相对平均扩散峰度(ratio of MK,rMK)、相对径向扩散峰度(ratio of RK,rRK)升高(P<0.05)，相对平均扩散系数(ratio of MD,rMD)降低(P<0.05),rMK、rRK、rMD的曲线下面积(area under the curve,AUC)分别0.94、0.83、0.70 (P<0.05)。复发组较假性进展组瘤周水肿的rMK升高、rMD降低(P<0.05),rMK、rMD的AUC分别0.82、0.73 (P<0.05)。脑室下区受累、增强病灶的rMK、rRK、rMD和瘤周水肿的rMK、rMD均与PFS具有相关性(P<0.05)。结论 DKI可用于鉴别胶质瘤复发与假性进展，参数值MK可作为较好的影像学标记，增强病灶的MK值是PFS的独立危险因素。

关键词(KeyWords)： 脑胶质瘤;复发;假性进展;扩散峰度成像;磁共振成像;瘤周水肿

Abstract:

Keywords:

基金项目(Foundation): 宁夏回族自治区重点研发计划(编号：2019BEG03037)~~

作者(Authors): 党佩;王立东;黄雪莹;刘静静;吕瑞瑞;杨治花;王晓东;

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