대한방사선기술학회지:방사선기술과학 (Journal of radiological science and technology)

  • 제32권4호
  • /
  • Pages.461-469
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  • 2009
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  • 2288-3509(pISSN)
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  • 2384-1168(eISSN)
대한방사선과학회 (Korean Society of Radiological Science)
권호 표지

뇌교종의 악성도 평가에서의 관류자기공명영상의 유용성에 관한 연구

A Study on the Usefulness of Perfusion MRI in Grading of Gliomas

  • 강현수 (을지대학교 보건과학대학 방사선학과) ;
  • 김종만 (을지대학교 보건대학원 방사선학과) ;
  • 고신관 (을지대학교 보건과학대학 방사선학과) ;
  • 문찬홍 (피츠버그대학교 의과대학 진단방사선과) ;
  • 유인규 (을지대학교 의과대학 영상의학과) ;
  • 한동균 (을지대학교 보건과학대학 방사선학과)
  • Khang, Hyun-Soo (Dept. of Radiological Science, College of Health Science, Eulji University) ;
  • Kim, Jong-Man (Dept. of Radiology, Graduate School of Public Health, Eulji University) ;
  • Ko, Shin-Kwan (Dept. of Radiological Science, College of Health Science, Eulji University) ;
  • Moon, Chan-Hong (Dept. of Radiology, College of Medicine, University of Pittsburgh) ;
  • Yu, In-Kyu (Dept. of Radiology, College of Medicine, Eulji University) ;
  • Han, Dong-Kyoon (Dept. of Radiological Science, College of Health Science, Eulji University)
  • 발행 : 2009.12.31
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초록

최근 신경계 질환의 진단에 많이 이용되는 관류자기공명영상기법 중 상대적 뇌 혈류량(relative cerebral blood volume)의 분석에 의한 뇌교종의 악성도 구분(고등급과 저등급 종양의 구분)에 있어 자기공명영상의 뇌 혈류량 검사의 유용성에 대하여 알아보고자 하였다. 뇌교종 환자 17명(평균연령 57.5세, 남자 11명, 여자 6명)을 대상으로 모든 환자에게 수술 전 관류자기공명 영상과 고식적 뇌 자기공명영상을 시행하고, 조직의 병리학적 검사를 시행하였다. 국소적 뇌 혈류량과 상대적 뇌 혈류량의 분석은 지멘스사의 소프트웨어(PAT)와 자체 개발한 영상 후 처리 소프트웨어 Xmap 2.0을 이용하여 비교, 분석하였다. 대상자 17명 중 뇌교종이 저등급인 6명과 고등급인 11명의 관류자기공명영상의 분석 결과는 저등급 뇌교종의 상대적 뇌 혈류량의 백질에 대한 종양부위의 평균 뇌 혈류량(rCBVw)의 평균은 1.62, 피질에 대한 종양부위의 평균 뇌 혈류량(rCBVc)의 평균은 0.12이었다. 고등급 뇌교종의 상대적 뇌 혈류량의 rCBVw의 평균은 33.53, rCBVc의 평균은 0.96이었다. 뇌교종과 반대측 뇌 백질과의 통계적인 상관성은 0.01(p-value)이었고. 뇌교종과 반대측 피질과의 통계적인 상관성은 0.02(p-value)로 나타났다. 결과 중 뇌교종과 뇌 백질의 통계분석수치가 뇌교종과 피질과의 통계분석 결과보다 더 유의한 결과를 나타내었다. 결국 두 가지 모두에서 유의한 결과를 나타냄을 알 수 있었다(p<0.05). 임상적으로 기존의 자기공명영상과 병리학적 결과와 함께 관류자기공명영상은 뇌교종의 등급을 판단하는데 있어 유용할 것으로 사료된다.

To predict the tumor grading, various imaging modalities have been applied clinically. This study determines clinical usefulness of perfusion MRI, using relative cerebral blood volume in grading of the gliomas. We did a retrospective review of 17 patients (mean age, 57.5 years; 11 male, 6 female) who underwent perfusion MR and conventional MRI, and then correlated pathologically after operation. Statistical analysis of regional cerebral blood volume and relative cerebral blood volume(rCBV) was performed by using softwares such as PAT by SIEMENS and Xmap ver 2.0 developed by ourselves. Six patients out of 13 were low-grade gliomas while eleven patients were the high-grade gliomas. Mean relative CBV (m_rCBV/white matter) in the low-grade gliomas was 1.62, and mean relative CBV(m_rCBV/cortex) was 0.12. In the high-grade gliomas, mean relative CBV(m_rCBV/white matter) and mean relative CBV(m_rCBV/cortex) were 33.53 and 0.96. Mean relative CBV of gliomas were elevated with a statistical difference(P<.05), compared with contralateral white matter(P=.019) or cortex(P=.025). Furthermore mean relative CBV(m_rCBV/white matter) was much higher than mean relative CBV(m_rCBV/cortex). Perfusion MRI using regional cerebral blood volume and rCBV is very useful imaging modality for grading the glioma.

키워드

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