高b值磁共振扩散加权成像在脑泡型包虫病边缘带的研究

摘要

目的：探讨不同 b 值 DWI 的定量指标 ADC 值对脑泡型包虫病边缘带的研究价值。方法收集2009年7月－2014年6月15例经病理诊断（8例）和临床诊断（7例）的 CAE 患者（共35个有效病灶）；应用 GE singa HDX3．0T 超导磁共振仪，分别进行全脑常规 MR 平扫、增强扫描及 DWI 检查，DWI 梯度敏感因子 b 值取1000 s／mm2和3000 s／mm2两组。分别测量病灶实质区、病灶周边0～10 mm 范围内脑实质区（灶周0～10 mm）、病灶周边10～20 mm（灶周10～20 mm）范围内脑实质区及对侧相应正常区域的脑的 ADC 值，并进行统计学分析。结果灶周水肿在 T1WI 上表现为低信号，在 T2WI 上呈高信号，T2Flair 序列上呈高信号，病灶实质在 b＝1000 s／mm2的 ADC 图上呈低信号，灶周水肿呈更低信号。病灶实质在 b＝3000 s／mm2的 ADC 图上呈低信号，灶周水肿呈更低信号，境界显示较 b＝1000 s／mm2更清晰。b 值为1000及3000 s／mm2时，病灶实质区与灶周0～10 mm 区 ADC 值比较差异无统计学意义（P ＞0．05）；b 值为1000及3000 s／mm2时，病灶实质区、灶周10～20 mm 区及对照区 ADC 值两两比较，差异均有统计学意义（P ＜0．05）。结论b 值为1000及3000 s／mm2，病灶区与0～10 mm 区 ADC 值具有同质性，提示 CAE 病灶边缘带存在泡状棘球蚴浸润。高 b 值 ADC 可以反映CAE 不同区域特征，并且有助于推测 CAE 浸润范围，为临床手术方案的制定及预后分析提供客观的影像学依据。%Objectives To investigate the significance of different b value Diffusion Weighted Imaging (DWI)ADC in marginal zone of Cerebral Alveolar Echinococcosis (CAE).Methods 15 cases of pathologi-cally diagnosed (8 cases)and clinically diagnosed (7 cases)CAE patients (35 focal areas in total)from July, 2009 to June,2014 were collected.GE singa HDx 3.0T MRI was used to perform regular MR scan,en-hanced sand and DWI scan.B value,the gradient sensitive factor,was set at 1 000 s/mm2 and 3 000 s/mm2 respectively to measure the ADC of the solid area of focal area,0 - 10 mm around the focal area (0 -10 mm area),10-20 mm around the focal area (10-20 mm area)and offside normal area ADC.Results When b=1 000 and 3 000 s/mm2 ,ADC difference between focal area and 0-10mm area does not show statistic significance (P >0.05);when b= 1 000 and 3 000 s/mm2 ,ADC shows statistically significant difference among focal area,10-20 mm area and control group,compared in pairs (P <0.05);when b=1 000 and 3 000 s/mm2,ADCs of the focal area and 0-10 mm area show homogeneity,indicating Alveolarhydatid cyst infiltration around the CAE focal area.Conclusion High b value ADC can reflect features ofdifference areas of CAE and contributes to speculate the scope of CAE infiltration,which can provide objective imaging evidences for clinical operation planning and postintervention analysis.