弥散加权成像在颅内单发环形强化病灶鉴别诊断中的价值  

The Value of DWI in Differentiating Intracranial Solitary Lesions Showing Ring--Enhancement

作　　者：陈小龙[1] 马强华[2] 陈纲[2] 叶建军[2] 杨晓萍[2] 

机构地区：[1]兰州大学第二临床医学院,甘肃兰州730030 [2]兰州军区兰州总医院MR室

出　　处：《实用放射学杂志》2009年第6期775-778,共4页Journal of Practical Radiology

摘　　要：目的探讨弥散加权成像（DWI）以及相对ADC（rADC）值在脑脓肿、高级别胶质瘤、单发脑转移瘤鉴别诊断中的价值。方法35例颅内单发环形强化病灶行DWI，分别测量并计算病变环内坏死区、近远侧周围水肿ADC值及相对ADC值（rADC值），同时以29例健康人脑脊液的rADC值为对照组，采用统计学软件SPSS10．0进行统计学分析。结果脑脓肿、高级别胶质瘤、脑转移瘤环内坏死区及正常人脑脊液的rADC值之间有统计学差异（F=146，P〈O．05）；3种疾病近侧周围水肿rADC值之间亦有统计学意义（F=17．8，P〈0．05），远侧周围水肿的rADC值之间无统计学意义（F=1．808，P〉0．05），3种疾病近远侧水肿之间均有统计学意义。结论大多数脑脓肿DWI环内呈高信号，高级别胶质瘤及转移瘤DWI环内呈低信号；高级别胶质瘤近侧周围水肿rADC值低于远侧，而转移瘤相反。Objective To discuss the value in differentiation of brain abscess,high grade gliomas and soliary metastases with diffusion-weighted imaging （DWI） and relative ADC （rADC） values. Methods 35 cases with intracranial solitary lesions which showed ring--enhancement were collected in this study. Both enhanced MR scanning and DWI were performed in all cases. The ADC values of the central necrosis of the lesions, the regions of surrounding edema and the cerebral parenchyma of opposite side were measured. The ADC values of CSF in 29 healthy persons were also measured as control group. The rADC values were analyzed statistically by SPSS 10.0. Results There were significant differences in rADC values among the central necrostic regions of abscess , glioma and metastasis as well as CSF in control group（F=146 ,P〈0.05）. The rADC values were prominently significant among of immediate perifocal edemas and were not significant among distant perifocal edemas（F = 17.8, P〈0.05; F= 1. 808, P〉0.05 ）. While,the rADC values in the rgeions of immediate perifocal edemas and diatante perifocal edemas in these three diseases were of significanes. Conclusion On DWI,the most of the brain abscesses were hyperintensity,but high--grade gliomas and metastatic tumors are hypointensity. The rADC values in immediate perifocal edemas of high--grade gliomas are lower than that in distant, but the metastases are opposite.

关 键 词：脑 磁共振成像 弥散加权成像 环形强化 脑脓肿 胶质瘤 转移瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]