磁共振扩散加权成像 ADC、EADC 脑泡型包虫病边缘带定量分析

摘要

Objective To investigate the magnetic resonance diffusion weighted imaging (DWI)quantitative indicators ADC,EADC in the study of cerebral alveolar echinococcosis marginal zone.Methods Collected 11 cases (23 lesions)diagnosed as cerebral alveolar echinococcosis during July,2009-March,2013 in our hospital,and applied 3.0T superconductive MRI apparatus to conduct whole brain conventional MR scan, enhanced scan,multi-voxel 1 H-MRS and DWI checks,DWI gradient sensitive factor b value were chosen 1 000 s/mm2 .The apparent diffusion coefficient (ADC), exponential apparent diffusion coefficient (EADC)in CAE lesion parenchyma,0 - 10 mm edema,10 - 20 mm edema and the contralateral corre-sponding parts of the brain parenchyma (control zone)were measured.Results ADC values in parenchy-ma,marginal zone were higher than the control zone,and gradually increased away from CAE parenchyma lesions,while EADC values gradually lower.The differences of ADC and EADC values in Parenchyma le-sions,marginal zone compared to the control zone were statistically significant (P <0.05);the differences of ADC in between 10-20 mm marginal lesion parenchyma and 0-10 mm marginal ,was statistically sig-nificant (P <0.05);the differences of ADC and EADC in between 0-10 mm marginalzone and parenchy-ma was not statistically significant.Conclusion DWI technique can reflect and evaluate CAE feature in le- sion parenchyma and marginal zone,which could not only contribute to differential diagnosis of CAE before surgery,but define the range of CAE infiltration zone,that will provider objective imaging evi-dences for establishing the surgery plan and prognosis analyzing .%目的：探讨磁共振扩散加权成像（DWI）定量指标 ADC、EADC 在脑泡型包虫病边缘带研究中的应用价值。方法收集2009年7月－2013年3月11例经新疆医科大学第一附属医院临床诊断为 CAE 患者共23个病灶；应用 GESinga HDX 3．0T 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。测量 CAE 病灶内部（病灶实质区）、0～10mm 边缘区、10～20mm 边缘区及对侧相应部位的脑实质区（对照区）表观扩散系数（apparent diffusion coefficient ADC）、指数表观扩散系数（exponential apparent diffusion coefficient EADC），并进行统计学分析。结果脑病灶实质区、边缘区 ADC 值高于对照区，远离 CAE 病灶实质区 ADC 值逐渐升高，EADC 值逐渐降低。病灶实质区、边缘区与对照区 ADC 值比较差异有统计学意义（P ＜0．05）；10～20 mm 边缘区与病灶实质区、0～10 mm 边缘区 ADC、EADC 值比较差异有统计学意义（P ＜0．05）；0～10 mm 边缘区与病灶实质区 ADC 值比较差异无统计学意义。结论DWI 技术可以反映并评价CAE 病灶实质及边缘带区域特征，此不仅有助于手术前 CAE 的鉴别诊断，并且有助于界定 CAE 浸润带范围，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。