肿瘤周边MRI征象在高级别胶质瘤与脑转移瘤中的鉴别诊断价值研究  

Value of MRI signs around tumor in differential diagnosis of high-grade glioma and brain metastasis

作　　者：陈自南 朱建英[1] 钟丽琴[1] 熊敏荣[1] 沈伟强[2] CHEN Zi-nan;ZHU Jianying;ZHONG Liqin(Department of Radiology,Huzhou Third People's Hospital,Huzhou 313000,China.)

机构地区：[1]湖州市第三人民医院放射科,浙江湖州313000 [2]湖州市中心医院放射科

出　　处：《全科医学临床与教育》2021年第10期893-895,F0002,F0003,共5页Clinical Education of General Practice

摘　　要：目的探讨肿瘤周边MRI征象在脑高级别胶质瘤(HGG)与脑转移瘤(BM)中的鉴别诊断价值。方法选择接受常规MRI检查并经病理证实的BM患者37例和HGG患者26例。比较BM和HGG患者的瘤周水肿表观扩散系数(ADC)值、肿瘤附近的皮层信号改变(SAAC)征和肿瘤边缘强化(PRS)征的差异,利用ROC曲线分析上述征象对BM和HGG的鉴别诊断价值。结果BM患者与HGG患者的瘤周水肿ADC值比较,差异无统计学意义(t=1.55,P>0.05)。HGG患者中有61.54%出现SAAC征,高于BM的16.22%,差异有统计学意义(χ^(2)=13.80,P<0.05)。HGG患者中有30.77%出现PRS征,低于BM的75.68%,差异有统计学意义(χ^(2)=12.57,P<0.05)。SAAC征鉴别诊断BM与HGG的曲线下面积为0.73(P<0.05),灵敏度61.54%,特异度83.78%;PRS征诊断BM与HGG的曲线下面积为0.73(P<0.05),灵敏度75.68%,特异度69.23%。结论肿瘤周边MRI征象SAAC征与PRS征对BM与HGG的鉴别诊断具有一定的临床应用价值。Objective To investigate the differential diagnostic value of MRI signs around tumor in high-grade glioma(HGG)and single brain metastasisr(BM).Methods Thirty-seven BM patients and 26 HGG patients were selected for MRI examination and pathologically confirmed.The differences in the ADC values of peritumoral edema,signal alteration in the adjacent cortex(SAAC)and peripheral rim sign(PRS)between BM and HGG patients were compared.ROC curve was used to analyze the differential diagnosis value of the above signs for BM and HGG.Results There was no signifi-cant difference in the ADC value of peritumoral edema between BM and HGG patients(t=1.55,P>0.05).Among HGG patients,61.54%had SAAC sign,which was higher than 16.22%of BM patients(χ^(2)=13.80,P<0.05).Among HGG patients,30.77%had PRS signs,which was lower than 75.68%of BM patients(χ^(2)=12.57,P<0.05).The area under the curve(AUC)of SAAC sign in the differential diagnosis BM and HGG was 0.73(P<0.05),and the sensitivity and spec-ificity were 61.54%and 83.78%,respectively.The AUC of PRS sign in differential diagnosis BM and HGG was 0.73(P<0.05),and the sensitivity and specificity were 75.68%and 69.23%,respectively.Conclusion The SAAC sign and PRS sign of tumor peripheral MRI have certain clinical application value for differential diagnosis of BM and HGG.

关 键 词：高级别胶质瘤 脑转移瘤 磁共振 鉴别诊断 

分 类 号：R739.41[医药卫生—肿瘤]