恶性胶质瘤与单发脑转移瘤的扩散加权成像鉴别诊断研究

摘要

Objective:To investigate the diffusion -weighted imaging of malignant gliomas and solitary brain me-tastasis to identify the role.Methods:To retrospectively analyze the data of 40 patients with malignant gliomas diag-nosed with solitary brain metastases,in different b value diffusion -weighted imaging scans.Results:In 40 patients, including 25 patients with malignant glioma,solitary brain metastasis 15 tumor patients,the tumor area signal values and ADC values of the two groups were statistically significant different in tumor periphery(P <0.05).Best b value different signal value,cut -off point was 5 000s/mm2 ,226.4 ×10 -3 mm2 /s.Sensitivity was 86.7%,specificity 56%, positive predictive value 54.2% and a negative predictive value 87.5%.ADC value differences optimal b value,cut-off point was 1 000s/mm2 ,1.40 ×10 -3 mm2 /s.Sensitivity was 100% and specificity 88%,positive predictive value 79%,negative predictive value 100%.Conclusion:With the change of b value,diffusion -weighted imaging of malig-nant gliomas and solitary brain metastasis to identify the role has changed,to the best b ADC value and cut -off point for the 1 000s/mm2 ,1.40 ×10 -3 mm2 /s when the identification of the role was the best,with a sensitivity of 100%and specificity 88%,positive predictive value 79%,negative predictive value 100%.%目的：探讨扩散加权成像对恶性胶质瘤与单发脑转移瘤的鉴别作用。方法：回顾自2006年6月份以来，入我院治疗的确诊为恶性胶质瘤与单发脑转移瘤的患者，在不同的 b 值下应用扩散加权成像进行扫描，获取瘤体及瘤周和正常侧组织的信号值及 ADC 值，评价不同 b 值下，扩散加权成像对恶性胶质瘤与单发脑转移瘤的鉴别作用。结果：共纳入患者40例，其中恶性胶质瘤患者25例，单发脑转移瘤患者15例。通过对照发现，两组患者的瘤体区域信号值及瘤周 ADC 值差异有统计学意义（P ＜0．05）。信号值差异最佳 b 值、截点分别为5000s／mm2、226．4×10－3 mm2／s，敏感性为86．7％，特异性为56％，阳性预测值为54．2％，阴性预测值为87．5％；ADC 值差异最佳 b 值、截点分别为1000s／mm2、1．40×10－3 mm2／s，敏感性为100％，特异性为88％，阳性预测值为79％，阴性预测值为100％。结论：随着 b 值的改变，扩散加权成像对恶性胶质瘤与单发脑转移瘤的鉴别作用有所改变，以 ADC 最佳 b 值和截点为1000s／mm2、1．40×10－3 mm2／s 时鉴别作用最佳，敏感性为100％，特异性为88％，阳性预测值为79％，阴性预测值为100％。