ADC值对儿童小脑肿瘤的鉴别诊断价值  

The application of diffusion weighted imaging in the diagnosis of common cerebellum tumors in children

作　　者：邓德茂[1] 李茂[2] 高振华[3] 何欣[1] 武莹莹[1] 袁文昭[1] 万荣超[1] 李敏[1] 

机构地区：[1]广西中医药大学第一附属医院放射科,530021 [2]广西医科大学第一附属医院放射科 [3]中山大学附属第一医院放射科

出　　处：《功能与分子医学影像学（电子版）》2012年第4期39-42,共4页Functional and Molecular Medical Imaging(Electronic Edition)

基　　金：广西自然科学基金(2011GXNSFA018176;0575016)

摘　　要：目的 探讨表观扩散系数（ADC）值在儿童小脑常见肿瘤鉴别诊断中的价值.方法 回顾性分析86例儿童小脑肿瘤的MRI表现,所有病例均进行了扩散加权成像（DWI）,测量肿瘤实质部分的ADC值并进行统计分析.结果 86例中,毛细胞型星形细胞瘤（Ⅰ级）23例,星形细胞瘤（Ⅱ级）15例,间变性星形细胞瘤（Ⅲ级）9例,胶质母细胞瘤（Ⅳ级）7例,室管膜瘤14例（Ⅰ级3例,Ⅱ级6例,Ⅲ级5例）,髓母细胞瘤（Ⅳ级）18例.肿瘤实质部分的ADC值由高到低依次为低级星形细胞瘤（Ⅰ～Ⅱ级）、室管膜瘤、高级星形细胞瘤（Ⅲ～Ⅳ级）和髓母细胞瘤,分别为（1.47±0.15）×10-3 mm2/s、（1.12±0.12）×10-3 mm2/s、（0.90±0.19）×10-3mm2/s和（0.73±0.09）×10-3 mm2/s,两两比较差异均有统计学意义（P＜0.05）.以ADC值0.82×10-3 mm2/s和1.32×10-3 mm2/s作为阈值诊断3组肿瘤（低级星形细胞瘤、室管膜瘤或高级星形细胞瘤、髓母细胞瘤）的正确率为94.2％（81/86）,室管膜瘤与高级星形细胞瘤的ADC值有较多重叠.结论 ADC值在儿童小脑常见肿瘤鉴别诊断中有重要价值.Objective To explore the applicative of ADC values in the diagnosis of common cerebellum tumors in children. Methods 86 cases with histologically proved primary cerebellum tumors were enrolled our study, from June 2003 to October 2013.The ADC value for each case were analysised retrospectively. Results 86 cases included 23 juvenile pilocytic astrocytomaes （grade Ⅰ ） ,15 astrocytomaes （grade Ⅱ ） ,9 anaplastic astrocytomaes （grade Ⅲ） , 7 glioblastomaes （grade Ⅳ） ,14 ependymaes （3 cases grade Ⅰ, 6 cases grade Ⅱ, 5 cases grade Ⅲ） and 18 medulloblastomaes. The ADC values of the solid part in tumors decreasely were astrocytomaes （grade I -II ） , ependymaes, senior astrocytomaes （grade Ⅲ-Ⅳ） and medulloblastomaes, and the ADC mean were （1.47 ± 0.15） x×l0-3 mm2/s, （1.12 ± 0.12） ×l0-3 mm2/s, （0.90 ± 0.19） ×l0-3 mm2/s and （0.73 ± 0.09） × 10-3 mm2/s. Differences of ADC values among these different types of tumors were statistically significant （P 〈 0.05 ） . If 0.82×10-3 mm2/s and 1.32× 10.3 mm2/s were used for diagnostic threshold in diagnosing astrocytomaes, ependymaes, senior astrocytomaes and medulloblastomaes, the correct rate was 94.2 % （81/86） . The ADC values of ependymaes and senior astrocytomaes had more overlap. Conclusion The ADC values in the diagnosis and differential diagnosis of common cerebellum tumors in children were very important.

关 键 词：儿童 脑肿瘤 扩散加权成像 表观扩散系数值 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]