表观弥散系数在原发颅内恶性淋巴瘤与高级别胶质瘤鉴别诊断中的作用  

The value of apparent diffusion coefficient in the differentiating diagnosis between primary intracerebral malignant lymphoma and high-grade glioma

作　　者：黄瑾瑜[1] 付志辉[2] 郭亮[1] 

机构地区：[1]苏州大学附属第一医院影像中心,江苏苏州215006 [2]苏州市中医医院放射科

出　　处：《实用放射学杂志》2011年第9期1325-1328,共4页Journal of Practical Radiology

摘　　要：目的 探讨表观弥散系数（ADC）在原发性颅内恶性淋巴瘤与高级别胶质瘤磁共振鉴别诊断中的作用.方法 回顾性分析经手术和病理证实的12例原发颅内恶性淋巴瘤、15例高级别胶质瘤的常规MRI表现和弥散加权成像（DWI）表现,对照分析肿瘤实质部分ADC值及对侧正常脑组织ADC值.结果 12例原发颅内恶性淋巴瘤,9例为单发,3例为多发.共发现18个病灶,15个病灶肿瘤实质DWI呈均匀高信号,肿瘤实质部分平均ADC值为（0.693±0.134）×10^-3 mm^2/s,对侧相应正常部位平均ADC值为（0.879±0.118） ×10^-3 mm^2/s,差异有统计学意义（P〈0.05）.15例高级别胶质瘤,14例单发,1例多发.共发现16个病灶,其中13例合并囊变坏死,病灶肿瘤实质DWI呈稍高或等信号,囊变坏死区呈明 显低信号.肿瘤实质部分平均ADC值为（0.913±0.125）×10^-3 mm^2/s,对侧相应正常部位平均ADC值为（0.826±0.098） ×10^-3 mm^2/s.原发颅内恶性淋巴瘤与高级别胶质瘤瘤体实质的平均ADC值在统计学上存在显著差异（P〈0.05）.结论 DWI表现及ADC值结合常规MRI平扫、增强表现,对颅内原发恶性淋巴瘤与高级别胶质瘤磁共振鉴别诊断具有重要价值.Objective To investigate the value of apparent diffusion coefficient （ADC） in the differentiating diagnosis between primary intracerebral malignant lymphoma and high-grade gliomas. Methods 12 cases with primary intracerehral malignant lymphoma and 15 cases with high-grade gliomas confimed pathologically, underwent conventional MRI, contrast-enhanced MRI and diffusion werghted imaging（DWI）. The imaging data were retrospectively analyzed. Results In 12 cases with primary intracerehral malignant lymphoma, there were totally 18 lesions,including single lesion in 9 and multiple lesions in 3. At DWI imaging, 15 lesions appeared as hyper-intensity,the mean ADC value was （0. 693±0. 134） 〉（ 10 3 mm^2/s, and that of corresponding contralateral normal area was （0. 879 ± 0.118） × 10^-3 m m^2/s, there was significant difference in ADC values between them （P〈0.05）. In 15 cases with highgrade gliomas,there were totally 16 foci including single lesion in 14 and multiple lesions in 1 ,of them,13 cases with cystic changes and necrosis were detected. On DWI , the lesions appeared as iso-and hyper-intensity and the areas of necrosis appeared as hypo-inten- sity , the mean ADC value was （ 0. 913±0. 125 ） × 10^-3 mm^2/s , and that of corresponding contralateral normal area was （0. 826± 0. 098） × 10^-3 mm^2/s. There were significant differences in ADC value between primary intracerehral malignant lymphoma and high-grade gliomas. Conclusion It is of significant value to combine DWI,ADC value,conventional MRI appearance and contrast-enhanced appearances in differentiating diagnosis of primary intracerebral malignant lymphoma from high-grade gliomas.

关 键 词：脑 磁共振成像 淋巴瘤 胶质瘤 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]