磁共振弥散加权成像对脑脓肿和脑内坏死、囊变肿瘤的鉴别诊断价值  

Discrimination of Brain Abscess from Necrotic or Cystic Tumors by Diffusion-Weighted MR Imaging

作　　者：周根泉[1] 张悦萍[1] 张贵祥[1] 朱晓江[2] 胡运胜[1] 诸慧铭[1] 陈丽萍[1] 

机构地区：[1]上海交通大学附属第一人民医院放射科,上海200080 [2]上海交通大学附属第一人民医院神经外科,上海200080

出　　处：《实用放射学杂志》2004年第11期966-968,994,共4页Journal of Practical Radiology

摘　　要：目的　研究磁共振弥散加权成像 (DWI)对脑脓肿和脑内坏死、囊变肿瘤的鉴别诊断价值。方法　对手术、病理证实的 9例脑脓肿、11例单发转移瘤、7例胶质瘤 (其中胶质母细胞瘤 5例 ,间变型星形细胞瘤 2例 )和 2例血管母细胞瘤做了常规的MRI和DWI。重点观察脑脓肿和坏死、囊变肿瘤在DWI上信号强度的变化 ,并对脑脓肿和肿瘤坏死、囊变部分的表观弥散系数 (ADC)值作 2个样本之间的秩和检验。结果　 9例脑脓肿在DWI上均呈明显的高信号 ,而 2 0例坏死、囊变的肿瘤在DWI上均呈低信号。脑脓肿中央部分的ADC值明显低于肿瘤坏死、囊变部分的ADC值 [( 0 .3 4± 0 .11)× 10 -3 mm2 /svs ( 2 .1± 0 .14 )× 10 -3 mm2 /s]。经统计检验 ,2组有显著性差异 (T =45 ,Ρ <0 .0 1)。结论　磁共振弥散加权成像对脑脓肿和脑内坏死。Objective To investigate the value of diffusion-weighted MR imaging (DWI) in differentiating brain abscesses from necrotic or cystic tumors.Methods 9 patients with proven brain abscesses and 20 patients with proven necrotic or cystic brain tumors (11 single metastases, 7 gliomas, 2 hemangioblastomas) were imaged with conventional MR imaging and diffusion-weighted imaging. The apparent diffusion coefficient (ADC) values in the central part of the abscess and the necrotic or cystic portion of the tumor were calculated and tested with two-sample rank sum test. Results On diffusion-weighted imaging, brain abscesses showed markedly hyperintense signal in all 9 patients, whereas necrotic or cystic tumors revealed hypointense signal in all 20 patients. The mean ADC value of brain abscesses was significantly lower than that of necrotic or cystic portions of brain tumors [(0.34±0.11)×10 -3 mm 2/s vs (2.1±0.14)×10 -3 mm 2/s, T=45, P<0.01].Conclusion Differential diagnosis can be made between brain abscess and necrotic or cystic brain tumor by diffusion-weighted imaging.

关 键 词：肿瘤 脑脓肿 囊变 坏死 DWI 脑内 磁共振弥散加权成像 信号强度 样本 

分 类 号：R730.264[医药卫生—肿瘤] R742.7[医药卫生—临床医学]