定量DTI参数在单发不典型脑转移瘤与高级别胶质瘤鉴别中的应用  

The Application Value of Quantitative DTI Parameters in the Differentiation of Single Atypical Brain Metastatic Tumor and High-Grade Glioma

作　　者：刘正 万水治[2] 彭立凤 胡敢峰[2] 郝青[2] LIU Zheng;WAN Shui-zhi;PENG Li-feng(Department of Radiology,Jiangbei Hospital of Jiangsu Prison Administration Bureau,Nanjing 210031,Jiangsu Province,China)

机构地区：[1]江苏省监狱管理局江北医院放射科,江苏南京210031 [2]中国人民解放军第八六医院医学影像科,安徽马鞍山243100

出　　处：《中国CT和MRI杂志》2020年第12期28-30,共3页Chinese Journal of CT and MRI

摘　　要：目的评价多个定量弥散张量成像(DTI)后处理参数在单发不典型脑转移瘤和高级别胶质瘤(HGG)鉴别中的应用价值。方法回顾分析病理证实的16例单发脑转移瘤(A组)和22例HGG(B组)患者的DTI数据,以近瘤周区及对侧为种子点重建DTI,观察白质纤维束的损伤情况,测量病灶、近瘤周区的各项异性指数(FA)、平均弥散系数(MD)和本征值(λ1、λ2、λ3),并计算轴向弥散系数(DA)和径向弥散系数(DR),分析各参数值在两组病灶及近瘤周区的差异。ROC曲线分析具有组间差异的参数在两组间的诊断效能。结果A组近瘤周区白质纤维束以浸润和移位为主,B组近瘤周区白质纤维束以破坏为主。两组病灶FA、MD、DA和DR值均无统计学差异(均P>0.05)。A组近瘤周区FA、MD、DA和DR值均高于B组(P<0.05)。ROC曲线示近瘤周区DA值具有最高的诊断效能,曲线下面积0.818,最佳诊断界值1.750,对应的敏感性和特异性分别为66.3%和85.5%,约登指数0.518。结论定量DTI参数有助于单发不典型脑转移瘤与HGG的鉴别诊断,以近瘤周区DA值诊断效能最高。Objective To evaluate the value of multiple quantitative diffusion tensor imaging(DTI)post-treatment parameters in the differentiation of single atypical brain metastatic tumor and high grade glioma(HGG).Methods The DTI data of pathologically confirmed 16 cases of single brain metastatic tumor(group A)and 22 cases of HGG(group B)were retrospectively analyzed.DTI was reconstructed base on seeds of the peri-tumor area and the contra to observe the injury of white matter fiber bundles.Measure fractional anisotropy(FA),mean diffusion coefficient(MD)eigenvalues(λ1,λ2,λ3)of lesions and the peri-tumor area,in addition,axial diffusion coefficient(DA)and radial diffusion coefficient(DR)were calculated.The differences of the parameter values of lesions and the peri-tumor area between the two groups were analyzed.ROC curve was used to analyze the diagnostic efficacy of parameters with difference between the two groups.Results In group A,the white matter fiber bundles in the peri-tumor area were mainly infiltration and displacement,while in group B,the white matter fiber bundles in the peritumor area were mainly destruction.There were no significant differences in FA,MD,DA and DR values of lesions between the two groups(all P>0.05).The values of FA,MD,DA and DR of the peri-tumor area in group A were higher than those in group B(all P<0.05).The ROC curve showed that the DA value of the peri-tumor area had the highest diagnostic efficiency,the area under the curve was 0.818,the optimal diagnostic threshold was 1.750,the corresponding sensitivity and specificity were 66.3%and 85.5%,and the Youden index was 0.518.Conclusion Quantitative DTI parameters are helpful for the differential diagnosis of single atypical brain metastatic tumor and HGG,and the highest diagnostic efficiency is achieved by DA value of the peri-tumor area,which can effectively assist in the correct diagnosis of disease types in clinic.

关 键 词：弥散张量成像 各项异性指数 弥散系数 转移瘤 胶质瘤 

分 类 号：R739[医药卫生—肿瘤] R445[医药卫生—临床医学]