T2信号强度在DTI鉴别脑肿瘤浸润与单纯血管性水肿中的价值  

The value of T2 signal intensity in DTI to differentiate between brain tumor infiltration and pure vasogenic edema

作　　者：闵志刚[1,2] 张明[2] 牛晨[2] 徐龙[1] 谢文超[1] 

机构地区：[1]宜兴市人民医院放射科,江苏宜兴214200 [2]西安交通大学第一附属医院影像中心,陕西西安710061

出　　处：《实用放射学杂志》2017年第11期1665-1667,1674,共4页Journal of Practical Radiology

基　　金：江苏大学医学临床科技发展基金项目（JLY20160029）.

摘　　要：目的 探索加入T2-信号强度（T2-SI）后扩散张量成像（DTI）在分辨肿瘤浸润和单纯瘤周水肿中的额外价值。方法 55例脑肿瘤（28例高级别胶质瘤、13例脑膜瘤和14例转移瘤）伴瘤周水肿的患者接受了DTI扫描。测量不同类型肿瘤瘤周水肿区的平均部分各向异性（FA）值、平均扩散率（MD）、纵向扩散率（λ∥）和轴向扩散率（λ⊥），并进行组间的比较。结果 组间比较显示仅高级别胶质瘤和脑膜瘤之间的平均FA值有显著差异（P〈0.05）。当将标准化的T2-SI作为协变量分析时，肿瘤组间的FA和λ⊥有显著差异。高级别胶质瘤水肿区校正的FA明显低于转移瘤（P〈0.05）和脑膜瘤（P〈0.001）。高级别胶质瘤水肿区的λ⊥明显高于脑膜瘤（P〈0.05）。结论 通过控制T2-SI的影响，DTI在区分肿瘤浸润和单纯水肿时可能有更大的价值。Objective To explore the added value of T2-signal intensity （T2-SI） in discriminating tumo-infiltration from pure vasogenic edema with diffusion tensor imaging （DTI）.Methods 55 patients with brain tumors [28 with high grade glioma （HGG）, 13 with meningioma, and 14 with metastases] and concurrent peritumoral edema were scanned with DTI. The mean fractional anisotropy （FA）, mean diffusivity （MD）, longitudinal diffusivity （λ//） and radial diffusivity （λ⊥） in peritumoral edema of different tumors were measured and compared with each other.Results Only the mean FA showed significant difference between edema of HGG and meningioma （P〈0.05）. When standardized T2-SI was used as the covariant, FA and λ⊥ showed significant differences among the tumor groups. The adjusted FA in edema of HGG was significantly lower than that of metastases （P〈0.05） and meningioma （P〈 0.001）. The adjusted λ⊥ in edema of HGG was significantly higher than that of meningioma （P〈0.05）.Conclusion By controlling the effect of T2-SI, the value of DTI in distinguishing tumor-infiltration from pure vasogenic edema could be improved.

关 键 词：脑肿瘤 水肿 浸润 扩散张量成像 

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