MRI扩散加权成像对血管瘤型脑膜瘤与非典型脑膜瘤的鉴别诊断价值  

The value of MRI diffusion-weighted imaging for differential diagnosis of angiomatous meningioma and atypical meningioma

作　　者：张学凌[1] 刘显旺 魏晋艳 王丹[1] 张鹏[1] 白亮彩[1] 周俊林[1] ZHANG Xue-ling;LIU Xian-wang;WEI Jin-yan;WANG Dan;ZHANG Peng;BAI Liang-cai;ZHOU Jun-lin(Lanzhou University Second Hospital,Second Clinical School,Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院,兰州大学第二临床医学院,甘肃兰州730030

出　　处：《中国临床医学影像杂志》2023年第9期615-619,共5页Journal of China Clinic Medical Imaging

基　　金：甘肃省科技计划资助项目(21YF5FA123);中华国际医学交流基金会-SKY影像科研基金(Z-2014-07-2101)。

摘　　要：目的:探讨MRI扩散加权成像(DWI)对血管瘤型脑膜瘤(Angiomatous meningioma,AM)与非典型脑膜瘤(Atypical meningioma,ATM)的鉴别诊断价值,以期提高术前诊断准确率。材料与方法:回顾性分析对比36例AM与54例ATM患者的基本资料、MRI常规影像学表现及ADC值的差异,绘制ROC曲线确定ADC值鉴别二者的诊断效能。结果:AM与ATM常规MRI表现中,二者的肿瘤体积(P=0.025)、窦侵犯(P=0.016)及病理结果脑侵犯(P=0.002)间比较有统计学差异,余各征象之间比较无统计学差异。AM组ADCmean((992.97±178.70)×10^(-6)mm^(2)/s)、ADCmin((956.39±172.24)×10^(-6)mm^(2)/s)、rADC(1.42±0.25)值均高于ATM组((814.04±178.91)×10^(-6)mm^(2)/s、(793.44±178.43)×10^(-6)mm^(2)/s、(1.14±0.25)),具有显著统计学差异(P均等于0.000)。ROC结果显示ADCmean、ADCmin及rADC值鉴别AM与ATM均具有较高的诊断效能,其AUC值分别为0.808(95%CI:0.712~0.884)、0.802(95%CI:0.705~0.879)、0.827(95%CI:0.732~0.898)。结论:DWI鉴别AM与ATM具有重要的临床意义,rADC值是提高二者术前诊断准确性最有价值的参数。Objective:To investigate the value of MRI diffusion-weighted imaging(DWI)in the differential diagnosis of angiomatous meningioma(AM)and atypical meningioma(ATM),in order to improving the preoperative diagnostic accuracy.Materials and methods:The clinical information,conventional MRI characteristics and the differences of ADC values of 36 cases of AM and 54 cases of ATM were retrospectively analyzed and compared.The receiver operating characteristic(ROC)curve was drawn to determine the diagnostic performance of ADC values in distinguishing AM from ATM.Results:In the conventional MRI manifestations of AM and ATM,there were statistical differences in tumor volume(P=0.025),sinus invasion(P=0.016),and pathological brain invasion(P=0.002)between the two,while there were no statistical differences between the other signs.The values of ADCmean((992.97±178.70)×10^(-6)mm^(2)/s),ADCmin((956.39±172.24)×10^(-6)mm^(2)/s),rADC(1.42±0.25)in AM group were significantly higher than those in ATM group((814.04±178.91)×10^(-6)mm^(2)/s,(793.44±178.43)×10^(-6)mm^(2)/s,(1.14±0.25),respectively;all P0.05).ROC analysis showed that ADCmean,ADCmin,and rADC values had high diagnostic performance in distinguishing AM from ATM,with AUC values of 0.808(95%CI:0.712~0.884),0.802(95%CI:0.705~0.879),and 0.827(95%CI:0.732~0.898),respectively.Conclusion:DWI plays an important role in distinguishing AM from ATM,and the rADC value is the most valuable parameter to improve the preoperative diagnostic accuracy of both tumors.

关 键 词：脑膜瘤 磁共振成像 

分 类 号：R739.45[医药卫生—肿瘤] R445.2[医药卫生—临床医学]