DWI在侧脑室中枢神经细胞瘤鉴别诊断中的价值  

Diffusion weighted imaging in differential diagnosis of central neurocytoma in the lateral ventricule

作　　者：贝天霞 程敬亮[1] 张勇[1] 薛康康 王朝艳[1] 

机构地区：[1]郑州大学第一附属医院磁共振科,河南郑州450052

出　　处：《实用放射学杂志》2015年第12期1946-1949,共4页Journal of Practical Radiology

摘　　要：目的 探讨扩散加权成像（DWI）和表观扩散系数（ADC）值对侧脑室中枢神经细胞瘤（CNC）和室管膜瘤的鉴别诊断价值。方法 回顾性分析经手术病理证实的18例侧脑室CNC和10例室管膜瘤患者常规平扫、增强MRI及DWI资料并测量肿瘤实质病变的平均ADC值，观察比较2组肿瘤的DWI信号强度和ADC值，运用受试者工作特征曲线（ROC）评价ADC值的诊断价值。结果 18例CNC在DWI上均呈高信号，ADC 均值（0.69 ±0.11）×10^-3mm^2/s；10例室管膜瘤DWI上7例呈等或稍高信号，3例呈低信号，ADC均值（1.10±0.24）×10^-3mm^2/s。对以上2种肿瘤的平均ADC值进行两样本t检验，差异有统计学意义（P＜0.01） 。ADC值诊断侧脑室CNC的ROC曲线下面积（AUC）为0.993±0.012，以0.83×10^-3mm^2/s为阈值时，诊断CNC的灵敏度为100%，特异度为92.9%。结论 常规MR检查联合DWI及ADC值是术前诊断及鉴别诊断侧脑室CNC和室管膜瘤的简单可靠方法。Objective To explore the value of diffusion weighted imaging （DWI） and apparent diffusion coefficient （ADC） value in differential diagnosis of central neurocytoma and ependymoma in the lateral ventricle. Methods 18 MR images of central neurocytomas and 10 MR images of ependymomas confirmed by pathology were retrospectively analyzed in this study. All patients performed conventional,post-contrast and diffusion weighted MR scan. The average ADC value was calculated in the solid part of tumors. The DWI signal and ADC values of two groups were compared. The receiver operating characteristic curves（ROC） were constructed to evaluate the diagnostic value of ADC. Results All of the central neurocytomas showed high signal on DWI image, and the average ADC value was （0. 69 ±0. 11） ×10^-3mm^2/s. In 10 lesions of ependyomas,isointensity/slightly hyperintensity was showed in seven patients and hypointensity in three patients on DWI image,and the average ADC value was （1.10±0.24）×10^-3mm^2/s. Two sample t-test were used to analyzed average ADC values of the two groups, which had statistically significant difference（P〈0.01）. The areas under the ROC curves of ADC diagnosing central neurocytomas of the lateral ventricle was 0. 993±0. 012, and by using optimal cut point of 0.83×10^-3mm^2/s for ADC of the lesion, the sensitivity and specificity were 100% and 92.9%, respectively. Conclusion DWI and ADC values combined with conventional MR imaging provides a simple and reliable method for preoperative diagnosis and differential diagnosis of central neurocytoma and ependymoma in the lateral ventricle.

关 键 词：扩散加权成像 表观扩散系数 中枢神经细胞瘤 

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]