DWI及ADC值鉴别后颅窝实质型血管母细胞瘤与其它富血供肿瘤的价值  

Values of DWI and ADC in differential diagnosis between parenchymal hemangioblastoma and other tumors with abundant blood supply in posterior cranial fossa

作　　者：黄兴涛[1] 柳彬 刘传[3] 李琦[3] 谭炜[1] 罗亚西[1] 陈永权[1] 

机构地区：[1]重庆市第五人民医院放射科,重庆400062 [2]重庆市涪陵区妇幼保健院,重庆648000 [3]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《放射学实践》2015年第4期319-322,共4页Radiologic Practice

摘　　要：目的:探讨磁共振扩散加权成像(DWI)及表观扩散系数(ADC)在鉴别后颅窝实质型血管母细胞瘤与其它富血供肿瘤中的应用价值。方法:经手术病理证实的15例后颅窝实质型血管母细胞瘤患者和28例其它富血供肿瘤(包括髓母细胞瘤5例,脑膜瘤5例,听神经瘤4例,室管膜瘤3例,转移瘤3例,淋巴瘤3例,间变型少突胶质细胞瘤1例,毛细胞型星形细胞瘤1例,间变性星形细胞瘤1例,胶质母细胞瘤1例,脉络膜乳头状瘤1例)患者,术前行MRI平扫、增强扫描和DWI检查,评估所有肿瘤病灶的DWI信号并测量ADC值,采用独立样本t检验对两组结果进行比较,并绘制受试者工作特征(ROC)曲线,评价ADC值对后颅窝实质型血管母细胞瘤的诊断效能。结果:15例后颅窝实质型血管母细胞瘤中,13例于DWI上呈低信号,2例呈等信号,平均ADC值为(2.06±0.46)×10-3 mm2/s;28例后颅窝其它富血供肿瘤中,18例于DWI上呈高信号,6例呈等信号,4例呈低信号,平均ADC值为(0.97±0.28)×10-3 mm2/s;两组中肿瘤的ADC值差异有统计学意义(t=8.373,P=0.000);ROC曲线下面积为0.979(P=0.000),以ADC值1.520×10-3 mm2/s作为阈值,诊断后颅窝实质型血管母细胞瘤的敏感度和特异度分别为93.3%和92.9%。结论:DWI及ADC值有助于鉴别后颅窝实质型血管母细胞瘤与其它富血供肿瘤,在实质型血管母细胞瘤的MRI检查中,DWI应作为一种重要的鉴别手段而纳入常规。Objective：To assess the value of diffusion-weighted imaging （DWI）and apparent diffusion coefficient （ADC）in differential diagnosis between parenchymal hemangioblastoma and other tumors with abundant blood supply in posterior cranial fossa.Methods：15 patients with parenchymal hemangioblastoma and 28 patients with other tumors which had abundant blood supply for comparison （including 5 cases of medulloblastoma,5 cases of meningioma,4 cases of acoustic neuroma,3 cases of ependymoma,3 cases of metastatic tumor,3 cases of lymphoma,1 case of anaplastic oligodendroglioma, 1 case of pilocytic astrocytoma,1 case of anaplastic astrocytoma,1 case of glioblastoma and 1 case of choroid plexus papillo-ma）were enrolled and underwent conventional MRI （pre- and post-contrast）and DWI examinations.All the tumors were in posterior cranial fossa and proved pathologically.DWI signal and ADC value of all the tumors were evaluated.The results of the two groups were compared by t-test for statistic analysis.The receiver operating characteristic （ROC）curve was drawn to evaluate the value of ADC for diagnosis of parenchymal hemangioblastoma and other tumors with abundant blood supply in posterior cranial fossa.Results：The signal of parenchymal hemangioblastoma on DWI was hypointense in 13 cases and isointense in 2 cases,while the signal of other tumors was hyperintense in 18 cases,isointense in 6 cases and hypointense in 4 cases.The mean ADC value of hemangioblastomas was （2.06±0.46）×10-3mm2/s,and that of other tumors with abun-dant blood supply was （0.97±0.28）×10-3mm2/s,the difference was statistically significant （t= 8.373,P= 0.000）.The area under the ROC curve was 0.979 （P= 0.000）.With ADC value of 1.520×10-3mm2/s as the threshold,the sensitivity and specificity were 93.3% and 92.9% respectively in diagnosis of parenchymal hemangioblastoma.Conclusion：DWI and ADC value are helpful to differentiate the parenchymal hemangioblastoma and other tumors with abundant blood supply in posterior cra

关 键 词：磁共振成像 扩散加权成像 表观扩散系数 血管母细胞瘤 脑肿瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R732.23[医药卫生—诊断学]