DWI在脑胶质瘤与脑转移瘤鉴别诊断中的应用

摘要

Objective To evaluate the values of diffusion weighted imaging (DWI) in the differential diagnosis of brain glioma and brain metastatic. Methods 38 cases of brain space occupying, 20 cases of brain glioma (WHO, grade ?10 cases, grade IV 20 cases, all cases were confirmed histologically) and 18 cases of brain metastases were collected. All the patients were given normal MRI examination and DWI examination. Value of ADC of tumor area, the surrounding area of tumor and normal control area were measured. Value of normalized ADC of tumor area (Radc-t)-value of ADC of tumor area/value of ADC of normal control area; value of normalized ADC of the surrounding area of tumor (Radc-p)=value of ADC of the surrounding area of tumor/value of ADC of normal control area. Results DWI test shown low signal levels in liquefy and necrosis areas of brain gliomas and brain metastases. In 20 cases of brain glioma, ADC values of tumor area and the surrounding area of tumor were higher than that of normal control area, and all groups had statisticall significant(all P< 0.05); in 18 cases of brain metastases, ADC values of tumor area and the surrounding area of tumor were higher than the value of c normal control area, and all groups hadstatistically significant (all P < 0.05). There were no statistical differences in Radc-t between brain gliomas and brain metastases (P > 0.05); Radc-p value of brain gliomas was significantly less than the value of brain metastases, and two groups of value had a significant difference (P < 0.05). Conclusion DWI can be used to iddentify brain glioma and brain metastases, and provide the best clinical treatment.%目的 评价弥散加权成像(DWI)在脑胶质瘤与脑转移瘤诊断和鉴别诊断中的应用价值.方法 收集38例脑内占位病例,20例脑胶质瘤(WHO分级Ⅲ级10例,Ⅳ级10例,均经手术病理证实),18例脑转移瘤,所有患者均行MRI常规检查和DWI检查.测量瘤体、瘤旁水肿区及对侧正常区的ADC值,瘤体区的标准化ADC值(rADC-t)=瘤体ADC值/对侧正常区ADC值;瘤旁水肿区的标准化ADC值(rADC-p)=瘤旁水肿区ADC值/对侧正常区ADC值.结果 脑胶质瘤与脑转移瘤的液化坏死区DWI上均呈低信号.20例胶质瘤瘤体及瘤旁水肿区的ADC值均高于对侧正常组织,且差异均有统计学意义(均P < 0.05).18例脑转移瘤瘤体及瘤旁水肿区的ADC值均高于对侧正常组织,且差异均有统计学意义(均P < 0.05).胶质瘤与脑转移瘤rADC-t值比较,差异无统计学意义(P > 0.05).胶质瘤的rADC-p值明显低于脑转移瘤,且差异有统计学意义(P < 0.05).结论 DWI可以用来帮助鉴别脑胶质瘤与脑转移瘤,从而为临床提供最佳的治疗方案.