ADC值可辅助鉴别原发性中枢神经系统淋巴瘤与高级别胶质瘤  

Study of Apparent Diffusion Coefficient in the Differentiation Between Primary Central Nervous System Lymphoma and High-grade Glioma

作　　者：孙军 付玏[2] 潘嘉炜 孙华平 潘康轶 SUN Jun;FU Le;PAN Jiawei;SUN Huaping;PAN Kangyi(Department of Radiology,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Radiology,Shanghai First Maternity and Infant Hospital,Tongji University)

机构地区：[1]上海市复旦大学附属华山医院影像科,上海市200040 [2]上海市同济大学附属第一妇幼保健院影像科

出　　处：《中国医学计算机成像杂志》2021年第1期6-9,共4页Chinese Computed Medical Imaging

摘　　要：目的:研究磁共振弥散加权成像(DWI)及表观弥散系数(ADC)用于辅助鉴别原发性中枢神经系统淋巴瘤(PCNSL)与高级别胶质瘤。方法:收集我院手术病理证实的20例PCNSL及20例高级别胶质瘤(WHO分级:Ⅲ~Ⅳ级)患者,进行磁共振DWI检查,分别记录肿瘤实质区域、瘤周水肿区域的ADC值,利用t检验进行2种肿瘤实质及水肿区的ADC值统计分析。结果:PCNSL多发8例,单发12例,DWI上17例病灶均见高信号,3例呈等信号,ADC图上均呈低信号。高级别胶质瘤单发16例,多发4例,DWI上18例病灶见低信号,2例呈稍高信号,ADC图上16例病灶见高信号。PCNSL实质部分ADC值(0.00143±0.00062)与高级别胶质瘤实质部分ADC值(0.00199±0.00060)差异有统计学意义(P<0.01);PCNSL水肿部分ADC值(0.00127±0.00023)与高级别胶质瘤水肿部分ADC值(0.00125±0.00017)未见统计学差异(P=0.726)。结论:肿瘤实质部分的ADC值可作为常规MRI检查的有效补充工具来鉴别PCNSL与高级别胶质瘤。Purpose: To study the value of diffusion weighted magnetic resonance imaging(MR-DWI) and apparent diffusion coefficient(ADC) to distinguish primary central nervous system lymphoma(PCNSL) from highgrade glioma. Methods: Twenty cases of PCNSL and 20 cases of high-grade gliomas(WHO grade: Ⅲ-Ⅳ)confirmed by surgical and pathological results in our hospital were collected. They were all scanned with MR-DWI,and the ADC values of the tumor parenchyma area and the peritumor edema area were recorded. The data was analyzed using the t-test. Results: In the PCNSL group, 8 cases were with multiple lesions, 12 cases with single lesion;17 cases on the DWI showed high intensity signal, 3 cases showed equal intensity signal, and the ADC map showed low intensity signal. In the high-grade glioma group, 16 cases were with single lesion, 4 cases were with multiple lesions;18 cases showed low intensity signal on the DWI image, 2 cases showed slightly higher intensity signal, and 16 cases showed high intensity signal on the ADC map. There were statistical differences of ADC values between PCNSL substantial part(0.001 43±0.000 62) and high-grade glioma parenchyma(0.001 99±0.000 60, P<0.01);There was no statistical difference of ADC values between PCNSL edema part(0.001 27±0.000 23) and high grade glioma edema part(0.001 25±0.000 17,P=0.726).Conclusion: The ADC value of the tumor parenchyma can be used as an effective supplementary tool for routine MRI examination to distinguish PCNSL from high-grade glioma.

关 键 词：原发性中枢神经系统淋巴瘤 高级别胶质瘤 表观弥散系数 肿瘤实质 

分 类 号：R445.2[医药卫生—影像医学与核医学]