CT与MRI结合评估脑胶质瘤分级的价值及指导放化疗的作用探究
The Value of CT Combined with MRI in Evaluating the Grade of Glioma and Its Role in Guiding Radiotherapy and Chemotherapy
赵康艳 1李锋 1贾岩龙 1王江涛 1陈华山1
作者信息
- 1. 湖北文理学院附属医院襄阳市中心医院影像科(湖北襄阳 441021)
- 折叠
摘要
目的 分析CT与磁共振成像(MRI)结合评估脑胶质瘤分级的价值,并探究其指导放化疗的作用.方法 选择2020年5月至2022年5月医院收治的86例脑胶质瘤患者,所有患者入院时均接受CT及MRI检查,以组织病理检查为基准,分析CT与MRI单独及联合评估脑胶质瘤分级与组织病理检查结果的一致性.结果 经组织病理检查结果显示,86例脑胶质瘤患者中脑胶质瘤I级9例(10.47％),Ⅱ 级29例(33.72％),Ⅲ级21 例(24.42％),Ⅳ级27例(31.40％);CT、MRI单独评估脑胶质瘤分级结果与组织病理检查结果一致性理想(Kappa=0.709、0.743,P＜0.05);CT与MRI联合评估脑胶质瘤分级结果与组织病理检查结果一致性极好(Kappa=0.823,P＜0.05);CT-MRI融合图像组GTV、临床靶区、计划靶区体积小于CT图像组(P＜0.05);CT-MRI融合图像组靶区受照最大剂量、平均剂量低于CT图像组(P＜0.05);CT-MRI融合图像组脑干、视神经、视交叉、垂体、晶体、眼球最大受照剂量及最小受照剂量均低于CT图像组(P＜0.05);随访1年,CT图像组复发率(32.56％)与CT-MRI融合图像组复发率(37.21％)比较,差异不显著(P＞0.05).结论 CT与MRI结合评估脑胶质瘤分级与组织病理检查一致性极好,具有较高临床应用价值,且在放化疗指导中具有重要作用,能够降低正常组织放疗照射剂量,保护正常组织.
Abstract
Objective To analyze the value of CT combined with magnetic resonance imaging(MRI)in evaluating the grade of glioma,and to explore its role in guiding radiotherapy and chemotherapy.Methods Eighty-six patients with glioma admitted to our hospital from May 2020 to May 2022 were selected.All patients were examined by CT and MRI when they were admitted to the hospital.Based on histopathological examination,the consistency between CT and MRI in evaluating the grade of glioma and histopathological examination was analyzed.Rtesults The results of histopathological examination showed that among the 86 patients with glioma,there were 9 cases of grade Ⅰ(10.47％),29 cases of grade Ⅱ(33.72％),21 cases of grade Ⅲ(24.42％)and 27 cases of grade Ⅳ(31.40％).The grading results of brain gliomas evaluated by CT and MRI alone are consistent with the results of histopathological examination(Kappa=0.709,0.743,P＜0.05).The results of CT and MRI combined assessment of glioma grading were in excellent agreement with histopathological examination(Kappa=0.823,P＜0.05).The volumes of GTV,clinical target and planned target in CT-MRI fusion image group were smaller than those in CT image group(P＜0.05).The maximum dose and average dose of target area in CT-MRI fusion image group were lower than those in CT image group(P＜0.05).The maximum dose and minimum dose of brain stem,optic nerve,optic chiasma,pituitary,lens and eyeball in CT-MRI fusion image group were lower than those in CT image group(P＜0.05).Follow-up for one year showed that the recurrence rate of CT image group(32.56％)was not significantly different from that of CT-MRI fusion image group(37.21％)(P＞0.05).Conclusion The combination of CT and MRI has excellent consistency with histopathological examination,has high clinical application value,and plays an important role in the guidance of radiotherapy and chemotherapy,which can reduce the radiation dose of normal tissue and protect normal tissue.
关键词
脑胶质瘤/CT/磁共振成像/放化疗指导Key words
Brain Glioma/CT/Magnetic Resonance Imaging/Guidance Of Radiotherapy and Chemotherapy引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据