DWI在胚胎发育不良性神经上皮瘤与低级别胶质瘤鉴别诊断中的价值  

DWI in differential diagnosis between dysembryoplastic neuroepithelial tumors and low-grade glioma

作　　者：韩雷 石慧娴 尚松安[2] 叶靖[2] 李青润 陈红日 张洪英[2] Han Lei;Shi Huixian;Shang Songan;ye Jing;Li Qingrun;Chen Hongri;Zhang Hongying(Department of Medical Imaging, Clinical Medical College of Yangzhou Universityy Yangzhou 225001, China;Department of Medical Imaging, Northern Jiangsu People's Hospital, Yangzhou 225001, China)

机构地区：[1]扬州大学临床医学院影像科,225001 [2]苏北人民医院影像科,扬州,225001

出　　处：《中华全科医师杂志》2019年第8期768-771,共4页Chinese Journal of General Practitioners

基　　金：国家自然科学基金面上项目(81471642).

摘　　要：对2014年1月至2018年8月苏北人民医院诊治、经病理检查诊断的11例胚胎发育不良性神经上皮瘤(DNET)、15例低级别胶质瘤(LGG)患者的影像检查资料,进行回顾性对照分析.均行常规MRI平扫、DWI及增强扫描,由工作站生成表观弥散系数(ADC)图,获取瘤肿实质区域和对侧正常参照区域的ADC值,得出相对(肿瘤/参照)ADC值(rADC值),分析比较肿瘤实质和对侧正常参照区域的ADC值以及两种肿瘤的rADC值.DNET和LGG组年龄[(16.6±13.1)与(43.0±19.2)岁]差异有统计学意义(t=3.938,P<0.01);6/11的DNET和0/15的LGG呈楔形或扇形(P<0.01);5/11的DNET和0/15的LGG在液体衰减反转恢复-T2加权成像(T2FLAIR)序列存在环状高信号(P<0.01);其他影像形态学特征(囊内分割、瘤周水肿及占位效应、强化、颅骨受压)差异无统计学意义(均P>0.05).两种肿瘤实质区域的ADC值均较对侧参照区域明显增高(均P<0.01),DNET患者的rADC值明显高于LGG患者(P<0.01).提示常规影像形态学有时难以鉴别DNET与LGG,rADC值对两者的术前鉴别有参考意义.Clinical and imaging data of 11 patients with dysembryoplastic neuroepithelial tumors (DNET) and 15 patients with low-grade glioma (LGG) admitted in Northern Jiangsu People's Hospital were analyzed retrospectively.Routine MRI scan,diffusion weighted imaging (DWI) and enhanced scan were performed.The workstation automatically generated apparent diffusion coefficient (ADC) maps and then to obtain ADC values of the tumor parenchymal area and the contralateral normal reference area.Relative tumor/reference ADC values (rADC) were also calculated.The ADC values of parenchymal regions of tumor and contralateral normal reference areas and the rADC between DNET and LGG were compared.There was significant difference in age distribution between the two groups [(16.6± 13.1) vs.(43.0± 19.2) years,t=3.938,P<0.01].Six out of 11 DNET cases and none of 15 LGG cases were cuneiform or fan-shaped (P<0.01);5/11 DNET and 0/15 LGG showed circular high signal in fluid attenuated inversion recovery-T2 weighted imaging (T2FLAIR) sequence (P<0.01),while there no significant differences in intracapsular segmentation,peritumor edema and mass effect,enhancement,and skull compression between two groups (all P>0.05).The ADC values of tumor parenchymal regions in both groups were significantly higher than those in contralateral reference regions (both P<0.01),the rADC of DNET was significantly higher than that of LGG (P<0.01).It is difficult to identify DNET and LGG by conventional image morphology,however the rADC value of DNET in DWI is significantly higher than that of LGG,and can provide important reference for differential diagnosis between them.

关 键 词：神经外胚瘤 原始 神经胶质瘤 磁共振成像 弥散 表观扩散系数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.4[医药卫生—诊断学]