磁共振扩散加权成像在脑泡型包虫病和高级别脑胶质瘤鉴别诊断中的应用

摘要

Objective To discuss the application value of Diffusion Weighted Imaging (DWI)in differential diagnosis of Cerebral Alveolar Echinococcosis (CAE)and High-grade Cerebral Glioma.Method 15 cases diagnosed of CAE and High-grade (WHO grade Ⅲ-Ⅳ)from 2009 to 2015 and 2013 to 2014 in The First Teaching Hospital of Xinjiang Medical University were collected respectively.All brain regular MR scan, enhanced scan and DWI were performed on patients with 3.0T MRI.Apparent Diffusion Coefficient (ADC) value of the focal area,edema area (0-10 mm around the focal area)and control area (the offside normal area)were measured respectively and analyzed statistically.Results The ADC value comparison between CAE and high-grade Cerebral Glioma shows statistic significance (t =-5.593,P <0.01)with ADC of Cer-ebral Glioma focal area higher than that of CAE.Statistic significance is also found in the ADC comparison between edema areas of CAE and high-grade Cerebral Glioma (t =-2.825,P <0.01)with edema area of Cerebral Glioma higher than that of CAE.Conclusion The combination of DWI and regular MRI provides valuable information in differential diagnosing CAE and High-grade Cerebral Glioma.%目的：探讨磁共振扩散加权成像技术（DWI）在脑泡型包虫病与高级别脑胶质瘤鉴别诊断中的应用价值。方法选择2009—2015年及2013—2014年在新疆医科大学第一附属医院分别确诊为脑泡型包虫病患者11例（有效病灶23个）及高级别（WHO Ⅲ～Ⅳ级）的脑胶质瘤患者20例（有效病灶20个）；应用3．0T 磁共振仪，分别对患者进行全脑常规 MR 平扫、增强扫描及 DWI 检查。分别测量病灶实质区、水肿区（病灶周边0～10 mm 范围水肿区）及对照区（对侧相应部位的正常脑实质区）的表观扩散系数（ADC）值，并进行统计学分析。结果脑泡型包虫病与高级别脑胶质瘤实质区 ADC 值比较，差异有统计学意义（t ＝－5．593，P ＜0．01），胶质瘤实质区的 ADC 值大于脑泡型包虫病实质区；脑泡型包虫病与高级别脑胶质瘤水肿区 ADC 值比较差异有统计学意义（t ＝－2．825， P ＜0．01），胶质瘤水肿区的 ADC 值大于脑泡型包虫病水肿区。结论DWI 与常规 MRI 联合应用，可为脑泡型包虫病与高级别脑胶质瘤的诊断及鉴别诊断提供有价值的信息。