DWI联合3D动脉自旋标记技术对鞍旁脑膜瘤与海绵状血管瘤的鉴别诊断价值  

Value of DWI combined with 3D-ASL in differentiation diagnosis of parasellar meningioma and cavernous hemangioma

作　　者：李强[1] 李晓伟 韩广[1] 李莹莹 魏本涛 刘晓朋 王富全 万振法[2] LI Qiang;LI Xiaowei;HAN Guang;LI Yingying;WEI Bentao;LIU Xiaopeng;WANG Fuquan;WAN Zhenfa(Department of Medical Imaging,Linyi Hospital of Traditional Chinese Medicine,Linyi 276003,China;Department of Radiology,Jinan Fourth People’s Hospital,Jinan 250031,China)

机构地区：[1]山东省临沂市中医医院医学影像科,山东临沂276003 [2]山东省济南市第四人民医院放射科,山东济南250031

出　　处：《中国中西医结合影像学杂志》2024年第3期294-297,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨DWI联合3D-ASL技术在鞍旁脑膜瘤与海绵状血管瘤的鉴别诊断价值。方法:回顾性分析经手术病理证实的鞍旁脑膜瘤与海绵状血管瘤各20例的MRI资料,分析平扫、增强扫描、DWI、3D-ASL图像特点,并测量最小ADC值及最大相对脑血流量(rCBF)。结果:鞍旁脑膜瘤多呈类圆形,T_(2)WI多呈等信号,增强扫描以早期中等程度强化常见,常见瘤周水肿及脑膜尾征;DWI多呈等高信号,最小ADC值(0.67~1.12)×10^(-3)mm^(2)/s,平均(0.76±0.13)×10^(-3)mm^(2)/s;多呈中高灌注,rCBF为5.072~9.683,平均7.062±3.571。海绵状血管瘤多呈哑铃状,T_(2)WI多呈高信号,增强扫描以充填式显著强化为主,未见瘤周水肿及脑膜尾征;DWI多呈低信号,最小ADC值(1.48~1.83)×10^(-3)mm^(2)/s,平均(1.56±0.25)×10^(-3)mm^(2)/s;多呈低灌注,rCBF为1.356~3.014,平均1.696±1.028。2组肿瘤形态、T_(2)WI信号、DWI信号、最小ADC值、强化方式、灌注信号及rCBF的差异均有统计学意义(均P<0.05)。结论:DWI联合3D-ASL技术在鞍旁脑膜瘤与海绵状血管瘤的鉴别诊断中具有较高的应用价值。Objective:To explore the value of DWI combined with 3D arterial spin labeling(3D-ASL)in differentiating parasellar meningioma from cavernous hemangioma.Methods:MRI data of 20 patients with parasellar meningioma and 20 patients with cavernous hemangioma confirmed by surgery and pathology were analyzed retrospectively.The characteristics of plain scan,enhanced scan,DWI,3D-ASL images were analyzed,and the minimum ADC value(ADCmin)and the maximum relative cerebral blood flow(rCBF)were measured.Results:Parasellar meningiomas were round in shape and isointense on T_(2)WI,with early moderate enhancement,peritumoral edema and meningeal tail sign in common.Parasellar meningiomas showed iso-and hyperintensity on DWI,and the ADCmin value ranged from 0.67×10^(-3)mm^(2)/s to 1.12×10^(-3)mm^(2)/s,with an average of(0.76±0.13)×10^(-3)mm^(2)/s.And most of them showed hyperperfusion,and the maximum rCBF was 5.072~9.683,with an average of 7.062±3.571.Most cavernous hemangiomas were dumbbell-shaped and hyperintensity on T_(2)WI,with significant fill-in enhancement in common,without peritumoral edema and meningeal tail sign.Cavernous hemangiomas showed hypointensity on DWI,and the ADCmin value ranged from 1.48×10^(-3)mm^(2)/s to 1.83×10^(-3)mm^(2)/s,with an average of(1.56±0.25)×10^(-3)mm^(2)/s.And most of them showed hypoperfusion,and the maximum nCBF was 1.356~3.014,with an average of 1.696±1.028.There were significant differences in tumor morphology,T_(2)WI and DWI signal,the ADCmin and rCBF values,enhancement pattern and perfusion between the two groups(all P<0.05).Conclusion:DWI combined with 3D-ASL has a high application value in the differential diagnosis of parasellar meningioma and cavernous hemangioma.

关 键 词：扩散加权成像 动脉自旋标记 鞍旁 脑膜瘤 海绵状血管瘤 

分 类 号：R739.45[医药卫生—肿瘤]