Application Of Perfusion Weighted Imaging In The Marginal Zone Of Cerebral Alveolar Echinococcosis And Its Correlation With Microvessel Density

Objective:To investigate the perfusion characteristics of cerebral alveolar echinococcosis(CAE),and to further clarify the boundary of the cerebral alveolar echinococcosis by the study of the marginal zone,and provide the imaging basis for the clinical operation.The correlation between quantitative index of magnetic resonance perfusion imaging(PWI)and microvessel density(MVD)in cerebral alveolar echinococcosis was compared.Methods: A total of 11 patients with cerebral alveolar echinococcosis were collected and 40 lesions were collected.The 3.0T superconducting magnetic resonance imaging was used to perform routine MR scan,enhanced scan and perfusion weighted imaging.The relative cerebral blood volume(rCBV),relative cerebral blood flow(rCBF),mean passing time(MTT)and peak time(TTP)were measured in the parenchymal area,edge area,edema area and control area of the cerebral vesicle type echinococcosis.SPSS20.0 software was used to analyze the changes of rCBV,rCBF,MTT and TTP in the parenchyma,marginal zone,edema area and control area of cerebral alveolar echinococcosis.The pathological sections of11 patients were collected and 1 cases were excluded.The MVD count was measured by immunohistochemical method,and the relationship between rCBV,rCBF,MTT,TTP and MVD in the marginal area of the lesion was analyzed.Results: The mean rank of rCBV in the parenchymal area,marginal area,edema area and control area of the cerebral alveolar echinococcosis were 187.70,310.53,188.52 and 285.26,respectively,and the mean values of the parenchymal area,marginal area,edema area and control area rCBF were 179.76,308.38,196.39,285.48,and the parenchyma,marginal area,edema area and MTT in the control area respectively.The rank mean values were 235.63,273.60,213.26 and 247.51,and the mean rank of the TTP in the parenchyma,the marginal area,the edema area and the control area were 293.53,247.15,243.39 and 185.93 respectively.The differences of rCBV,rCBF and TTP in the parenchymal area of cerebral alveolar echinococcosis were statistically different from those in marginal area,edema area and control area 22.The results showed that the rCBV value in the marginal area was the highest,the blood supply was the most abundant,and the rCBV value in the parenchymal area was the lowest,which was relative to the blood supply.The average MVD count in the marginal area of echinococcosis was 39.63 ± 5.72 /high magnification.The Spearman method was used to analyze the positive correlation between rCBV and rCBF of echinococcosis,and R values of 0.886 and 0.796 respectively(P < 0.05).Conclusion:Magnetic resonance perfusion imaging has certain significance in the diagnosis of cerebral alveolar echinococcosis and its application in the marginal zone.The rCBV value of magnetic resonance perfusion imaging can evaluate the density and content of microvascular in cerebral echinococcosis,to a certain extent,reflect the formation of blood vessels on the edge of the lesion.By the study of the marginal zone,the surgical boundary is further defined in the clinic,and it is of guiding significance in the surgical treatment.