瘤体实质ADC值及EDC值在颅内淋巴瘤与Ⅲ～Ⅳ级星形细胞瘤鉴别中的应用  

The Application of ADC and EDC Value in Differentiation Between Intracranial Lymphoma and Grade Ⅲ～Ⅳ Astrocytoma

作　　者：李辉[1] 陈兵[2] 翟伟 李春花[1] 石洋洋 

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院放射科,银川750004 [3]宁夏中卫市海原县人民医院放射科,755200

出　　处：《临床放射学杂志》2014年第2期171-174,共4页Journal of Clinical Radiology

基　　金：2009年度宁夏自然科学基金项目(编号:NZ09220)

摘　　要：目的探讨瘤体实质表观扩散系数（ADC）值、指数表观扩散系数（EDC）值在颅内淋巴瘤与Ⅲ～Ⅳ级星形细胞瘤鉴别中的价值。方法搜集术后病理确诊的19例颅内淋巴瘤和45例Ⅲ～Ⅳ级星形细胞瘤患者的影像学资料，包括常规MRI平扫、增强扫描和扩散加权成像（DWI），测量瘤体实质区、瘤体对侧正常脑白质区的ADC值及EDC值。应用受试者工作特征（ROC）曲线对ADC值和EDC值对两种肿瘤的诊断效能进行评价，然后对两组肿瘤的瘤体实质ADC值、EDC值、相对表观扩散系数（rADC）值、相对指数表观扩散系数（rEDC）值分别进行两样本t检验。结果ADC值及EDC值对两种肿瘤都有诊断效能，但EDC值的诊断效能低于ADC值。颅内淋巴瘤的瘤体实质ADC值低于Ⅲ～Ⅳ级星形细胞瘤（t=一7．416，P=0．004），rADC值低于Ⅲ～Ⅳ级星形细胞瘤（t=-7．181，P=0．003），EDC值高于Ⅲ～Ⅳ级星形细胞瘤（t=8．101，P=0．030），rEDC值高于Ⅲ～Ⅳ级星形细胞瘤（t=8．055，P=0．002）。结论颅内淋巴瘤与Ⅲ～Ⅳ级星形细胞瘤瘤体实质ADC值、EDC值、rADC值、rEDC值结合DWI图像及常规MRI平扫＋增强有助于两种肿瘤的鉴别诊断，瘤体实质ADC值及EDC值的测量对两种肿瘤的鉴别有很大的应用价值。Objective To explore the value of ADC and EDC in differentiating intracranial lymphoma and grade Ⅲ - Ⅳ Astroeytoma. Methods 19 cases of intracranial lymphoma and 45 cases of grade Ⅲ- Ⅳ Astrocytoma underwent MR examination, including conventional MRI, enhanced MRI and DWI. The ADC and EDC value were measured in the enhan- cing tumor paranchyma, the contralateral normal white matter and edema area of tumor respectively. ROC curve was used to evaluate the diagnosis efficiency of ADC and EDC in differential diagnosis of intraeranial lymphoma and grade Ⅲ- Ⅳ astro- cytoma. The ADC , EDC, rADC and rEDC value in intracranial lymphoma were compared with those in grade Ⅲ- Ⅳ astro- cytoma using two tailed t test.. Results ADC and EDC values had diagnosis efficiency in differential diagnosis of in- traeranial lymphoma and grade Ⅲ - Ⅳ astroeytoma, but diagnosis efficiency of EDC value was lower than that of ADC val- ue. ADC value in the tumor center of intracranial lymphoma was lower than that in grade Ⅲ- Ⅳ astrocytoma（ t = -7. 181, P =0. 003 ） , rADC value in intracranial lymphoma was lower than that in grade Ⅲ - Ⅳ astrocytoma（ t = - 7. 181, P = 0. 003 ） ,EDC value in intracranial lymphoma was higher than that in grade Ⅲ- Ⅳ astroeytoma（ t = 8. 101, P = 0. 030 ） , rEDC value in intracranial lymphoma wass higher than that in grade Ⅲ - Ⅳ astrocytoma（ t = 8. 055,P = 0.002）. ADC val- ue, EDC value, rADC value and rEDC value have statistical significance difference between intracranial lymphoma and grade Ⅲ- Ⅳ astrocytoma. Conclusion ADC value and EDC value in the area of enhancing tumor parenchyma has help to differentiate intracranial lymphoma and gradeⅢ- Ⅳ astrocytoma.

关 键 词：表观扩散系数 指数表观扩散系数 淋巴瘤颅内 星形细胞瘤 

分 类 号：R739.41[医药卫生—肿瘤]