扩散峰度成像对高级别胶质瘤及单发脑转移瘤的鉴别诊断价值

摘要

目的:探讨磁共振扩散峰度成像(DKI)的多参数值对高级别胶质瘤(HGG)和单发脑转移瘤(SBM)的鉴别诊断价值.方法:搜集经手术病理或临床随访证实的19例HGG患者和14例SBM患者的病例资料,术前均行常规MRI扫描、DKI扫描及增强扫描.选取兴趣区(ROI)测定其DKI参数,并进行矫正处理得到各向异性分数(FA)、平均扩散(MD)及平均峰度(MK)值.应用独立样本t检验对两组间各参数值进行统计学分析,绘制ROC曲线计算敏感度、特异度及曲线下面积(AUC).结果:两组肿瘤实质区DKI各参数值差异无统计学意义(P＞0.05);而瘤周区的FA值、MD值及MK值在两组间的差异有统计学意义(P＜0.05).ROC曲线分析显示,瘤周区的MK值鉴别两种肿瘤的敏感度和特异度较FA值和MD值高,曲线下面积最大.结论:瘤周区的FA值、MD值及MK值对HGG和SBM有良好的鉴别诊断价值,且瘤周区MK值诊断效能最高.%Objective:To study the value of MR diffusion kurtosis imaging (DKI) in the differential diagnosis of high-grade glioma (HGG) and solitary brain metastases (SBM).Methods:The clinical materials of 19 patients with HGG and 14 patients with SBM proven by pathology or clinical follow-up were collected.All patients had conventional MRI, DKI and enhanced MRI before surgery.ROI were drawn to measure the DKI parameters,which were corrected in order to obtain the FA, MD and MK values.The parameters of the two groups were compared by independent samples t test.ROC curves were drawn and the sensitivity,specificity and area under curve (AUC) were calculated.Results:No significant statistical difference was existed in the DKI parameters of the solid region in the 2 types of tumor (P＞0.05).Yet there were statistical differences in FA,MD and MK values in the peri-tumoral region (P＜0.05).ROC analysis showed that the MK value in peri-tumoral area for differentiating the 2 types of tumor was higher than that of peri-tumoral FA and MD values,and the value of AUC was the highest.Conclusion:The peri-tumoral FA, MD and MK values provides helpful information in the differential diagnosis of HGG and SBM,and the efficacy of peri-tumoral MK value was the highest.