MR扩散张量成像在脑囊性坏死性肿瘤与脓肿鉴别诊断中的价值  

Study of diffusion tensor imaging in necrotic brain tumors and abscess

作　　者：史瑞华[1] 祁明臣 翟仁友[1] 钱晓军[1] 鲁万红[1] 顾华[1] 

机构地区：[1]首都医科大学附属北京朝阳医院放射科,北京100020 [2]山东省胸科医院,山东济南250013

出　　处：《中国临床医学影像杂志》2006年第8期421-424,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:评价MR扩散张量成像在脑囊性坏死性肿瘤与脓肿中的鉴别诊断价值。方法:经病理或临床复查证实的胶质母细胞瘤12例、单发转移瘤10例、脑脓肿9例。行常规MR平扫和增强、扩散张量成像(DTI)检查。构建平均扩散系数(ADC)图和各向异性分数(FA)图,并测量病灶中心坏死区的ADC、FA值。结果:脓肿腔DTI表现为高信号;胶质母细胞瘤和转移瘤中心坏死区呈低信号。在ADC图上,脓肿呈低信号,平均ADC值为(0.66±0.07)×10-3mm2?s;胶质母细胞瘤和转移瘤均呈高信号,脓肿与胶质母细胞瘤、转移瘤ADC值具有显著性差异(P=0.000<0.05)。在FA图上,病灶中心均表现为低信号。结论:在DTI扩散张量加权像上,脓肿表现为较特异的高信号,ADC值较低,有助于和囊变、坏死性肿瘤鉴别。Objectives： To evaluate the diagnostic value of diffusion tensor imaging（DTI） in brain tumors with necrosis and abscesses. Materials and Methods： Nine brain abscesses, 12 glioblastomas, 10 metastases confirmed clinically or pathologically underwent conventional MRI and DTI. Average diffusion coefficient（ADC） value, fractional anisotropy（FA） value and map was calculated in the central portion. Results： On DTI, The abscesses displayed as hyperintense signal; but glioblastoma and metastasis all showed hypointense signal. On ADC map, the abscesses showed hypointense signal, the mean ADC value was （0.66±0.07）×10^-3mm^2/s, The difference between abscess and necrotic tumors was statistically significant（P=0.000〈0.05）; glioblastoma and metastasis all demonstrated as hyperintense signal. Abscess, glioblastoma, metastases and peri-edema all were depicted as hypointense signal on FA map. Conclusion： Abscesses show special hyperintense signal on DTI and have low ADC value. DTI is helpful in differentiating abscess from glioblastoma and metastasis.

关 键 词：脑肿瘤 脑脓肿 磁共振成像 弥散 诊断 鉴别 

分 类 号：R739.41[医药卫生—肿瘤] R742.7[医药卫生—临床医学]