磁共振DTI技术定量参数在脑淋巴瘤与高级别胶质瘤鉴别中的应用  

The application of quantitative parameters of magnetic resonance DTI technique in differentiating brain lymphoma from high-grade glioma

作　　者：张玉柱[1] 李林[1] 李大鹏[1] 张玲[1] 周小兵[1] 吴飞云[1] ZHANG Yuzhu;LI Lin;LI Dapeng;ZHANG Ling;ZHOU Xiaobing;WU Feiyun(Department of Radiology,The First Affliated Hospital With Nanjing Medical University,Nanjing 210029,P.R.China)

机构地区：[1]南京医科大学第一附属医院放射科

出　　处：《医学影像学杂志》2019年第12期2019-2022,共4页Journal of Medical Imaging

摘　　要：目的评价磁共振弥散张量成像(DTI)技术多个定量参数在脑淋巴瘤和高级别胶质瘤(HGG)鉴别中的应用价值。方法回顾分析我院经病理证实的11例脑淋巴瘤(A组)和23例HGG(B组)患者的DTI数据。使用后处理软件测量病灶、瘤周水肿以及正常对侧脑组织(NC)的各项异性指数(FA)、表观弥散系数(ADC)和本征值(λ1、λ2、λ3)。由本征值计算轴向弥散系数(DA)和径向弥散系数(DR)。分析各参数值在病灶及瘤周水肿区的改变,并比较各参数值在两组间的差异。ROC曲线分析两组病灶ADC、DA和DR值在两组间的诊断效能。结果DTI三维重建显示两组病灶区白质纤维束均以破坏为主。两组FA、ADC、DA和DR值由NC、瘤周水肿至病灶均呈逐渐下降(均P<0.05)。A组病灶ADC、DA和DR值均低于B组(均P<0.05)。两组病灶FA值和瘤周水肿的FA、ADC、DA和DR值均无统计学差异。ROC曲线示病灶DA值具有最高的鉴别诊断效能,曲线下面积0.824,最佳诊断界值1.060,约登指数0.553。结论DTI技术定量参数ADC、DA和DR值有助于脑淋巴瘤与HGG的鉴别诊断,可辅助临床医师及早判断病情并选择合理的治疗方案。Objective To evaluate the value of multiple quantitative parameters of magnetic resonance diffusion tensor imaging(DTI)in differentiating brain lymphoma from high-grade glioma(HGG).Methods The DTI data of 11 cases of brain lymphoma(group A)and 23 cases of HGG(group B)were retrospectively analyzed.Post-treatment software was used to measure fractional anisotropy(FA),apparent diffusion coefficient(ADC)and eigenvalues(λ1,λ2,λ3)of the lesions,peritumoral edema,as well as normal contralateral brain tissue(NC).The axial diffusion coefficient(DA)and radial diffusion coefficient(DR)were calculated from the eigenvalues.The changes of parameter values in the lesion and peritumoral edema area were analyzed,and the differences between the two groups were compared.ROC curve was used to analyze the diagnostic efficacy of ADC,DA and DR values between the two groups.Results DTI three-dimensional reconstruction showed that the white matter fiber bundles in the lesions of both groups were mostly destructive.FA,ADC,DA and DR values in both groups were gradually decreased from NC,peritumoral edema to lesions(all P<0.05).The values of ADC,DA and DR of lesions in group A were all lower than those in group B(all P<0.05).There were no significant differences in FA value of lesions as well as FA,ADC,DA and DR values of peritumoral edema areas between the two groups.The ROC curve showed that the DA value of lesions had the highest diagnostic efficiency,the area under the curve was 0.824,the optimal diagnostic threshold was 1.060,and the Youden index was 0.553.Conclusion The quantitative parameters of DTI technology,including ADC,DA and DR values,are helpful for the differential diagnosis of brain lymphoma and HGG,and can assist clinicians in early diagnosis of the disease and selection of a reasonable treatment plan.

关 键 词：淋巴瘤 胶质瘤 磁共振成像 弥散张量成像 各项异性指数 表观弥散系数 

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