扩散张量成像在不同病理类型的星形细胞肿瘤鉴别中的应用  

Differentiating different pathological types of astrocytic tumours by diffusion tensor imaging

作　　者：聂泰明[1] 姜兴岳[2] 秦东京[2] 张林[2] 李泉[2] 王宁[2] 

机构地区：[1]滨州医学院,山东省滨州市256603 [2]滨州医学院附属医院,山东省滨州市256603

出　　处：《实用医学杂志》2014年第12期1898-1902,共5页The Journal of Practical Medicine

基　　金：山东省自然科学基金资助项目(编号:ZR2011HL038)

摘　　要：目的:探讨扩散张量成像(DTI)在鉴别不同病理类型的星形细胞肿瘤中的价值。方法:收集67例不同病理类型星形细胞肿瘤患者,所有病例均行T1WI、T2WI、FLAIR、T1WIGd-DTPA增强扫描和DTI检查,均经病理证实。分别测量肿瘤瘤实质区与正常脑白质区的ADC值,分析比较不同病理类型星形细胞肿瘤实质区和健侧正常脑白质区ADC值,用统计学软件SPSS 19.0分别对ADC值进行统计学分析,统计结果均以x±s表示,P<0.05为差异有统计学意义。结果:纤维型星形细胞瘤、肥胖细胞型星形细胞瘤、间变性星形细胞瘤及巨细胞型胶质母细胞瘤肿瘤实质区、健侧正常脑白质区ADC值(<10-9mm2/s)分别为(1.48±0.12、0.72±0.05)、(1.31±0.07、0.69±0.03)、(1.06±0.11、0.71±0.04)、(0.98±0.09、0.73±0.04)。纤维型星形细胞瘤与肥胖细胞型星形细胞瘤肿瘤实质区ADC值比较有统计学差异(P<0.001);纤维型星形细胞瘤和肥胖细胞型星形细胞瘤与间变性星形细胞瘤肿瘤和巨细胞型胶质母细胞瘤肿瘤实质区ADC值比较均有显著统计学差异(P<0.001);间变性星形细胞瘤与巨细胞型胶质母细胞瘤肿瘤实质区ADC值比较无统计学差异(P=0.07>0.05)。结论:测量肿瘤实质区ADC值可鉴别不同病理类型的星形细胞肿瘤,但是难以区分间变性星形细胞瘤和巨细胞型胶质母细胞瘤;DTI对星形细胞肿瘤术前评价有较高的实践价值。Objective To determine whether the different pathological types of astrocytic tumours can be differentiated by diffusion tensor MR imaging. Methods In this study, diffusion tensor MR imaging was performed preoperatively in 67 patients with different pathological types of astrocytic turnouts. Furthermore, T1WI, T2WI, FLAIR and T1WI enhancement scanning by GD-DTPA were performed preoperatively in all patients. The Mean diffusivity （ADC） values in the tumor parenchyma and normal white matter from different pathological types of astrocytic tumours were measured and analyzed. The ADC with the tumor parenchyma and normal white matter from the turnouts were statistically analyzed by SPSS 19.0. The results were expressed as ±s and P 〈 0.05 was regarded as statistically significant differences. Results There were many differences with ADC （〈 10^-9 mm^2/s） in the tumor parenchyma between fibrillary astrocytoma （1.48 ± 0.12,0.72 ±0.05） from fat cell astrocytoma （1.31 ± 0.07, 0.69 ± 0.03）, There were also many differences with ADC（ 〈 10^-9 mm^2/s） in the tumor parenchyma between fibrillary and fat cell astrocytoma from anaplastic astrocytoma （1.06 ± 0.11, 0.71 ± 0.04） and giant cell glioblastoma （0.98 ± 0.09, 0.73± 0.04）. There were not differences with ADC in the tumor parenchyma between anaplastic astrocytoma from giant cell gliobastona. Conclusion Measurement of tumor parenchyma＇s ADC values can identify different pathological types of astrocytie tumours, but not between anaplastic astrocytoma and giant cell glioblastoma. DTI is essential to preoperative evalution of astrocytic tumours.

关 键 词：扩散张量成像 表观扩散系数 星形细胞肿瘤 

分 类 号：R739.4[医药卫生—肿瘤]