评价ADC值对橄榄桥小脑萎缩的诊断价值  

The value of apparent diffusion coefficient in diagnosis of OPCA

作　　者：苗培芳 王彩鸿 李鹏[1] 程敬亮[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》2016年第1期17-19,71,共4页Journal of Practical Radiology

摘　　要：目的 评价表现扩散系数（ADC）值对橄榄桥小脑萎缩（OPCA）的诊断价值。方法 （1）选取经临床诊断为OPCA的52例患者及25例年龄匹配的正常人作为对照组，行常规MRI检查（T1WI、T2WI、DWI）。根据MRI表现将患者分为轻度组和重度组。轻度组：小脑脑沟增多、脑干稍变细，桥脑无明显改变；重度组：小脑脑沟增多，桥脑、延髓橄榄萎缩，第四脑室、脑干基底池扩大。（2）选取桥脑、小脑中脚和小脑半球为感兴趣区（ROI）并测量其ADC值。运用单因素方差对3组ROI的ADC值进行统计分析。结果 3组ROI的ADC值差异有统计学意义（P〈0.05）。OPCA患者组（轻度组及重度组）ROI的ADC值较对照组明显升高，差异有统计学意义（P〈0.05）。OPCA重度组ROI的ADC值较轻度组升高，且重度组病程长于轻度组，差异均有统计学意义（P〈0.05）。结论 桥脑、小脑中脚、小脑半球的ADC值对OPCA有重要的诊断价值，尤其对于MRI表现不明显的OPCA轻度组患者具有重要的诊断意义。Objective To evaluate the value of apparent diffusion coefficient （ADC） in diagnosis of OPCA. Methods 52 OPCA patients and 25 age-matched control subjects were recruited. Subjects were scanned on a 3.0T MR with sequences including T1WI, T2 WI and DWI. Patient group was divided into mild and severe sub-groups in accordance with characteristics features in MRI images. The mild group showed increased cerebellar sulcus, slightly thinner brainstem, but no visible change of the pontine; while severe group showed severe atrophy of pontine ventral and medulla oblongata olive, enlarged fourth ventricle, and expanded brainstem basal cistern. Then we chosen the pontine, cerebellar peduncle, and cerebellar hemisphere as three regions of interest（ROI） to measured the ADC values. Then One Way ANOVA test was used to statistical analysis. Results The two sub-groups all had the larger ADC in the three ROI than the control group（P〈0. 05）. The ADC of severe group was higher than that of the mild group（P〈0. 05）. The course of the severe group was longer than the mild group. The differences reach statistical significance （P〈0. 05）. Conclusion The measurement of the ADC on the pontine, cerebellar peduncle, and cerebellar hemisphere have important values in the diagnosis on OPCA, which may be helpful in the early diagnosis of the disease.

关 键 词：橄榄桥小脑萎缩 扩散加权成像 表观扩散系数 磁共振成像 

分 类 号：R742.82[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]