瘤周水肿区DTI在高级别胶质瘤与转移瘤鉴别诊断中的应用  

Utility of peritumoral DTI in differentiating high-grade gliomas and cerebral metastases

作　　者：魏弢[1] 尹化斌[1] 孟凡华[1] 林丽萍[1] 

机构地区：[1]复旦大学附属上海市第五人民医院放射科,上海200240

出　　处：《医学影像学杂志》2015年第10期1713-1716,共4页Journal of Medical Imaging

基　　金：上海市闵行区自然科学基金(编号:2012MHZ064)

摘　　要：目的探讨瘤周水肿区DTI鉴别高级别胶质瘤(HGG)与转移瘤的价值。方法选取经病理及临床证实的HGG 19例和转移瘤13例患者,均行常规MR和DTI检查。以距肿瘤强化边缘4mm、10mm为界,将瘤周水肿区划分为近瘤周水肿区、中瘤周水肿区及远瘤周水肿区,分别测量两组肿瘤不同瘤周水肿区的ADC值、FA值。结果 HGG近瘤周水肿区与中瘤周水肿区ADC值均低于转移瘤(t=2.175,P<0.05;t=2.692,P<0.05),两组肿瘤的远瘤周水肿区ADC值无统计学差异,HGG与转移瘤不同瘤周水肿区的FA值均无统计学差异。HGG近瘤周水肿区与中瘤周水肿区ADC值低于远瘤周水肿区(F=5.929,P<0.01),FA值无统计学差异;转移瘤不同瘤周水肿区的ADC值、FA值均无统计学差异。结论 DTI能反应HGG瘤周水肿区肿瘤细胞浸润存在渐变现象,瘤周10mm内水肿区的ADC值,有助于HGG与转移瘤鉴别。Objective To discuss the value of DTI in peritumoral edema in differentiating high-grade gliomas （HGG） from cerebral metastases. Methods 19 patients of HGG and 12 patients of metastases proved by pathology and clinic data were involved in this study. All patients underwent conventional and diffusion tensor MR imaging. The peritumoral edema regions were divided into proximal peritumoral region, intermediate peritumoral region and distal peritumoral region, according to the distance of 4 millimetres and 10 millimetres away from the enhancing edge of the tumor. The ADC values and FA values in different peritumoral edema regions of HGG and metastases were measured respectively. Results In proximal and intermediate peritumoral regions, the ADC values of HGG were lower than those of metastases （ t =2. 175, P （0.05~ t = 2. 692, P （0.05）. In distal peritumoral region, the ADC values of HGG showed no statistically significant difference from metastases. In proximal and intermediate peritumoral regions, the ADC values of HGG were significantly lower than those in distal peritumoral region （ F =5. 929, P （0.01）, the FA values showed no statistically significant difference. The ADC values and FA values of metastases in different peritumoral regions showed no statistically significant difference. Conclusion DTI can demonstrate tumor infiltration surrounding HGG with gradient phenomenon, the ADC values in 10 mm-wide band immediate peritumoral region are helpful in distinguishing HGG from metastases.

关 键 词：胶质瘤 转移瘤 弥散张量成像 瘤周水肿 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]