DWI和ADC值在原发性中枢神经系统非霍奇金淋巴瘤中的鉴别诊断价值  

Diagnostic Value of DWI,ADC in Patients with Primary Central Nervous System Non-Hodgkin's Lymphoma

作　　者：陈兵[1] 金国宏[1] 侍明海[1] 张丽芳[2] 郝少才[3] 张军[4] 李国福[4] 

机构地区：[1]宁夏医学院附属医院放射科,银川750004 [2]宁夏医学院附属医院神经内科,银川750004 [3]宁夏医学院附属医院神经外科,银川750004 [4]宁夏医学院附属医院病理科,银川750004

出　　处：《宁夏医学院学报》2008年第3期319-322,F0004,共5页Journal of Ningxia Medical College

摘　　要：目的探讨弥散加权成像(DWI)和表观弥散系数(ADC)值在原发性中枢神经系统非霍奇金淋巴瘤(PC- NSL)中的鉴别诊断价值。方法经手术后病理证实的13例原发性中枢神经系统非霍奇金淋巴瘤的DWI信号视觉观察和ADC值测量进行回顾性分析。与手术后病理证实的36例星形细胞瘤(Ⅰ～Ⅱ级16例,Ⅲ～Ⅳ级20例),40例脑膜瘤,18例转移瘤进行对照分析。结果PCNSL组:DWI图像上以高信号为主(7/9);ADC值为(0.84±0.29)×10^(-3)mm^2/s。星形细胞瘤组:DWI图像上Ⅰ～Ⅱ级星形细胞瘤以低信号为主(7/16);ADC值为(1.68±0.50)×10^(-3)mm^2/s。Ⅲ～Ⅳ级星形细胞瘤以低信号和混杂信号为主(14/20),ADC值为(1.42±0.69)×10^(-3)mm^2/s。脑膜瘤组:DWI图像上以高信号为主(21/40);ADC值为(0.90±0.21)×10^(-3)mm^2/s。转移瘤组:DWI图像上以低信号为主(10/18);ADC值为(1.43±0.71)×10^(-3)mm^2/s。PCNSL与星形细胞瘤(P=0.002)和转移瘤(P=0.006)的ADC值差异有统计学意义,与脑膜瘤(P=0.524)的ADC值差异无统计学意义。结论PCNSL的DWI和ADC值与星形细胞瘤和转移瘤具有鉴别诊断价值,与脑膜瘤无鉴别诊断价值。Objective To explore the diagnostic value of DWI, ADC in patients with PCNSL. Methods DWI,ADC of 13 patients with PCNSL who were confirmed by postoperative histology were retrospectively analyzed. And 36 cases with casesastrocytoma （ Ⅰ - Ⅱ grade 16,Ⅲ - Ⅳ grade 20） ,40 cases with Meningioma and 18 cases with metastatic tumor were comparatively analysed. Results In PCNSL group DWI showed hyperintense in 7 cases of 9 cases, ADC values were （0.84 ± 0.29） × 10^-3 mm^2/s. In Astrocytic glioma group（ grade Ⅰ and Ⅱ） DWI showed hypointense in 7 cases of 16 cases,ADC values were（1.68 ±0.50） × 10^-3mm^2/s. In Astrocytic glioma group（grade Ⅲ - Ⅳ ） DWI showed hypointense and mixedintense in 14 cases of 20 cases, ADC values were （ 1.42 ± 0.69） × 10^ - 3mm^2/s. In meningioma group DWI showed hyperintense in 21 cases of 40 cases, ADC values were （0.90 ± 0.21 ） × 10^-3mm^2/s. In Metastatic tumor group DWI showed hypointense in 7 cases of16 cases , in10 cases of18 , ADC values were （1. 43 ± 0 . 71） ×10 ^- 3mm^2/s . Conclusion TheADCvalues of PCNSL, astrocytoma and metastatic tumor showed significant differense. But there were no significant difference between PCNSL and meningioma.

关 键 词：弥散加权成像 表观弥散系数 磁共振成像 非霍奇金 

分 类 号：R739.4[医药卫生—肿瘤]