DWI及ADC值鉴别脑脓肿与坏死囊变脑转移瘤的价值  

Values of DWI and ADC in differential diagnosis between brain abscesses and necrotic or cystic metastatic brain tumors

作　　者：黄敏华[1] 郭勇[1] 林伟[1] 钱明珠[1] 张永文[1] 

机构地区：[1]海军总医院磁共振室,北京100037

出　　处：《第四军医大学学报》2007年第5期438-441,共4页Journal of the Fourth Military Medical University

摘　　要：目的:研究DWI及ADC值在鉴别脑脓肿与坏死囊变脑转移瘤中的应用价值.方法:病理及临床证实脑脓肿14例,坏死囊变脑转移瘤17例,经常规磁共振检查及弥散加权检查,在脑脓肿脑炎期、包膜期及吸收期进行弥散信号及ADC值的测量,并与坏死囊变脑转移瘤相比较,统计学分析采用χ2检验和t检验.结果:脑脓肿包膜期DWI为高信号,ADC值低,与坏死囊变脑转移瘤DWI及ADC值正好相反.吸收期及脑炎期脑脓肿DWI为低信号或等信号,而ADC值高信号或等信号,与坏死囊变脑转移瘤正好相类似.所有脑脓肿的平均ADC值为0.88×10-3mm2/s,坏死囊变脑转移瘤平均ADC值1.8×10-3mm2/s,两者比较有统计学差异(P<0.05).DWI信号诊断的敏感性为64.5%(20/31),特异性为100%(17/17),准确性为77%(37/48).结论:DWI及ADC值有助于鉴别包膜期脑脓肿与坏死囊变脑转移瘤,对吸收期脑脓肿与坏死囊变脑转移瘤的鉴别诊断无明显意义.AIM： To study the values of diffusion-weighted imaging （DWI） and apparent diffusion coefficient （ADC） in the differential diagnosis between brain abscesses and necrotic or cystic metastatic brain tumors. METHODS： Fourteen patients proved pathologically as brain abscess and 17 cystic/necrotic metastatic tumor underwent conventional MRI and DWI examinations. DWI signal and ADC value were evaluated in cerebritis stage, capsule formation stage, and evolution stage of brain abscess and compared with those of cystic/necrotic metastatic tumor. Chi-squared test and t test were performed for statistic analysis. RESULTS： The DWI signal was high and ADC value was low in the capsule stage of abscess, which was contrary to that of cystic/necrotic tumor. The DWI signal was low or equal and ADC value was high or equal in the evolution stage or cerebritis stage, which was similar to that of cystic/necrotic tumor. The mean ADC value of all brain abscesses was （0.88 × 10^ -3 ） mm^2/ s, and that of cystic/necrotic tumor was （ 1.8 × 10^-3 ） mm^2/s; the difference was statistically significant （ P 〈 0.05 ）. The diagnostic sensitivity, specificity and accuracy of DWI signals were 64.5% （20/31）, 100% （17/17）, 77% （37/48） respectively. CONCLUSION： DWI and ADC value are helpful to differentiate capsule formation stage of abscess from cystic/necrotic tumor, but not belpful to distinguish evolution stage/cerebritis stage of abscess from cystic/necrotic tumor.

关 键 词：磁共振成像 弥散加权成像 ADC值 脑脓肿 脑肿瘤/继发性 

分 类 号：R445.2[医药卫生—影像医学与核医学]