DWI在颅内淋巴瘤与Ⅲ-Ⅳ级星形细胞瘤鉴别诊断中的应用  

Application of DWI to Differentiation between Intracranial Lymphoma and Ⅲ-Ⅳ Grade Astrocytoma

作　　者：李辉[1] 翟伟 陈兵[3] 

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

出　　处：《宁夏医科大学学报》2014年第4期368-371,F0002,F0004,共6页Journal of Ningxia Medical University

基　　金：宁夏自然科学基金(NZ09220)

摘　　要：目的探讨瘤体实质部分和瘤周水肿区的ADC值在颅内淋巴瘤与Ⅲ-Ⅳ级星形细胞瘤中的鉴别诊断价值。方法收集我院术后病理确诊的20例颅内淋巴瘤和48例Ⅲ-Ⅳ级星形细胞瘤的完整影像学资料,包括常规MRI平扫、增强扫描和弥散加权成像,测量瘤体实质部分、瘤体对侧正常脑白质区及瘤周水肿区的ADC值。然后对两组肿瘤的瘤体实质部分的ADC值、rADC值和瘤周水肿区的ADC值分别进行比较。结果两组肿瘤瘤体对侧正常脑白质区ADC值无统计学意义;颅内淋巴瘤的瘤体实质部分的ADC值明显低于Ⅲ-Ⅳ级星形细胞瘤(t=-7.438,P=0.002),rADC值亦低于Ⅲ-Ⅳ级星形细胞瘤(t=8.106,P=0.002),颅内淋巴瘤与Ⅲ-Ⅳ级星形细胞瘤瘤周水肿区ADC值差异无统计学意义。结论颅内淋巴瘤与Ⅲ-Ⅳ级星形细胞瘤瘤体实质部分ADC值、rADC值结合DWI图像及常规MRI平扫+增强有助于两组肿瘤的鉴别诊断,瘤周水肿区ADC值的测量对两组肿瘤的鉴别意义不大。Objective To explore if ADC value of the enhancing tumor and edema area can be used to differentiate intracranial lymphoma and Ⅲ-Ⅳ grade Astrocytoma.Methods The complete imaging material of 20 cases with intracranial lymphoma and 48 cases with Ⅲ-Ⅳ grade Astrocytoma were collected,including conventional MRI,enhanced MRI and DWI.Lesions were analyzed with the imaging findings retrospectively.The ADC value was measured on the enhancing tumor,the contralateral nor-mal-appearing white matter and edema area of tumor respectively.The ADC values and rADC values in intracranial lymphoma were compared with those in Ⅲ-Ⅳ grade astrocytoma as by using a two tailed t test.Results ADC value in regions of interest in the tumor center of intracranial lymphoma was significantly lower than that in Ⅲ-Ⅳ grade astrocytoma（t =8.106,P=0.002）.rADC value in the tumor center of intracranial lymphoma was significantly lower than that in Ⅲ-Ⅳ grade astrocytoma（t =8.106,P =0.002）.ADC value showed no significant difference in edema area between the intracranial lymphoma and Ⅲ-Ⅳ astrocytoma.Conclusion ADC value and rADC value of the enhancing tumor have significant difference between intracranial primary central nervous system lymphoma and Ⅲ-Ⅳ grade astrocytoma.

关 键 词：弥散加权成像 淋巴瘤 颅内 Ⅲ-Ⅳ级星形细胞瘤 

分 类 号：R739.4[医药卫生—肿瘤]