脑转移瘤磁共振弥散加权像与原发肿瘤病理学相关性初步探讨  

Magnetic Resonance Diffusion-weighted Imaging of Brain Metastases and Primary Tumors Pathology

作　　者：李晓夫[1] 高颖[2] 赵明[1] 张铁成[1] 付旷[1] 

机构地区：[1]哈尔滨医科大学附属第二医院磁共振成像诊断科,黑龙江哈尔滨市150086 [2]哈尔滨工业大学医院放射科,黑龙江哈尔滨市150001

出　　处：《中国康复理论与实践》2011年第3期274-276,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨磁共振(MRI)弥散加权成像(DWI)在脑转移瘤诊断中的价值,及转移瘤DWI弥散受限与原发肿瘤组织病理间的相关性。方法 76例脑转移瘤患者根据原发肿瘤病理进行分组,分别测定肿瘤实质、坏死囊变区、瘤周水肿及正常脑实质表观弥散系数(ADC);计算肿瘤在DWI上呈现高信号(即弥散受限)病例的比值,并统计与原发肿瘤病理之间的相关性。结果转移瘤病灶部位平均ADC:实质区(1.1364±0.310)×10-3mm2/s,囊变坏死区(2.167±0.472)×10-3mm2/s,周围水肿区(1.597±0.238)×10-3mm2/s,正常脑实质区(0.812±0.158)×10-3mm2/s(P<0.05)。有15例转移病灶出现弥散受限(19.7%),弥散受限病例原发肿瘤为肺癌的10例(66.6%),其中5例为小细胞肺癌,5例为非小细胞肺癌;3例原发肿瘤为乳腺癌;另2例原发肿瘤为结肠癌和睾丸畸胎癌(P>0.05)。弥散受限转移瘤实质部分最小ADC(0.72±0.16)×10-3mm2/s和无弥散受限转移瘤最小ADC(0.78±0.21)×10-3mm2/s也无显著性差异(P=0.325)。结论 DWI能反映脑转移瘤的组织病理变化;弥散受限的肿瘤与原发组织病理学无相关性。Objective To study the application of magnetic resonance imaging （MRI） diffusion-weighted imaging （DWI） in brain metastases,and the relationship between DWI results and the primary tumor pathology.Methods76 cases with brain metastases were grouped according to the primary cancer pathology.The apparent diffusion coefficient （ADC） of tumor parenchyma,capsule area,edema around tumors and normal parenchyma were determined;the ratio of high signal on the DWI were calculated （namely diffusion limited） in different tumor.ResultsThe ADC was （1.1364±0.310）×10-3 mm2/s in tumor parenchyma,（2.167±0.472）×10-3 mm2/s in capsule,（1.597±0.238）×10-3 mm2/s in edema and （0.812±0.158）×10-3 mm2/s in normal parenchyma （P0.05）.15 cases appeared diffusion limited （19.7%）,in which the primary tumors were lung cancer in 10 patients （66.6%） （including 5 cases with small cell lung cancer,5 cases with none small cell lung cancer）,breast cancer in 3 cases,and the other 2 cases were colon cancer and teratocarcinoma of testis （P0.05）.The minimum ADC were （0.72±0.16）×10-3 mm2/s in tumor parenchyma with diffuse limited metastases and （0.78±0.21）×10-3 mm2/s without diffuse limited （P=0.325）.ConclusionDWI can respond to brain metastases to the microstructure change,but diffusion limited may not be related with the primary histopathology.

关 键 词：脑转移瘤 磁共振成像 弥散加权成像 表观弥散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学]