研究动态增强磁共振成像（DCE-MRI）中的各参数指标对听神经鞘瘤的血供来源评估中的应用价值，为听神经鞘瘤的临床治疗提供客观的分析依据。

纳入南京医科大学附属脑科医院神经外科自2019年9月至2021年1月收治的16例听神经鞘瘤患者为研究对象，同时选择8例无听神经鞘瘤病史患者为对照组。16例听神经鞘瘤患者均于术前行常规MRI平扫+增强，再行DCE-MRI扫描，注射对比剂之后，根据DCE-MRI图像强化部位分为内听道组（6例）和颅内组（10例）；对照组行DCE-MRI扫描。应用PHILIPS影像处理工作站对所有DCE-MRI图像进行后处理，获取时间-信号强度曲线（TIC）及半定量参数：最大信号强度（SImax）、达峰时间（TTP）、最大上升斜率（MSI）、对比剂摄取率（WIR）。将对照组、内听道组及颅内组的TIC类型构成及半定量参数值进行统计学分析，采用χ²检验及Kruskal-Wallis检验进行组间比较。

对照组TIC Ⅰ、Ⅱ、Ⅲ型分别为8、0、0例，内听道组分别为0、1、5例，颅内组分别为4、6、0例，3组比较差异均有统计学意义（P<0.05）；内听道组与颅内组比较，差异有统计学意义（P<0.05）。对照组SImax、TTP、MSI、WIR均小于内听道组和颅内组，差异均有统计学意义（P<0.05）；内听道组SImax、TTP、WIR与颅内组比较，差异均无统计学意义（P>0.05）；内听道组MSI大于颅内组，差异有统计学意义（P<0.05）。

DCE-MRI的TIC及半定量参数中的MSI对于鉴别听神经鞘瘤的血供来源是经颅内（椎-基底动脉系统）还是内听道（颈外动脉分支）有一定意义。

To study the application value of various parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in evaluating the blood supply of acoustic schwannoma, and to provide objective analysis basis for clinical treatment of acoustic schwannoma.

Sixteen patients with acoustic schwannoma admitted to neurosurgery department of the Affiliated Brain Hospital of Nanjing Medical University from September 2019 to January 2021 were selected as the research objects, and 8 patients without acoustic schwannoma history were selected as the control group. Sixteen cases of acoustic neurilemmoma were performed conventional MRI scan and contrast enhancement before operation, and then underwent DCE-MRI scan. After injection of contrast agent, they were divided into internal auditory canal group (6 cases) and intracranial group (10 cases) according to the enhancement site of DCE-MRI image; the control group underwent DCE-MRI scan. All DCE-MRI images were post processed by Philips image processing workstation to obtain tic curve and semi quantitative parameters, including maximum signal intensity (SImax), time to peak (TTP), maximum slope of increase (MSI), wash in rate (WIR). The time signal intensity curve (TIC) types and semi-quantitative parameter values of the control group, internal auditory canal group and intracranial group were statistically analyzed, and the χ² test and Kruskal-Wallis test were used for comparison between groups.

In the control group, TICs of type Ⅰ, Ⅱ and Ⅲ were 8, 0, and 0 cases, respectively. In the internal auditory canal group, TICs of type Ⅰ, Ⅱ and Ⅲ were 0, 1, and 5 cases, respectively. In the intracranial group, TICs were Ⅰ, Ⅱ and Ⅲ were 4, 6, and 0 cases, respectively. The difference between the control group and the internal auditory canal group, intracranial group was statistically significant (P<0.05); Comparing the internal auditory canal group with the intracranial group, the difference was statistically significant (P<0.05). SImax, TTP, MSI, WIR of control group are all lower than those of the internal auditory canal group and the intracranial group, the differences were statistically significant (P<0.05). There were no significant differences in SImax, TTP, WIR between the internal auditory canal group and the intracranial group (P>0.05); MSI in the internal auditory canal group was higher than that in the intracranial group (P<0.05).

The TIC of DCE-MRI and the MSI in the semi quantitative parameters have certain significance for identifying whether the blood supply of acoustic schwannomas is transcranial (vertebral-basal artery system) or internal auditory canal (external carotid artery branch).