磁共振DWI在判断小儿颅内肿瘤分级中的价值

摘要

目的:探讨磁共振DWI在判断小儿颅内肿瘤分级中的价值.方法:回顾性分析60例经病理证实小儿颅内肿瘤的扩散加权成像(DWI)及ADC图像,包括WHO Ⅰ级19例,Ⅱ级17,Ⅲ级14例,Ⅳ级10例.测量肿瘤实质部分及正常脑白质的ADC值,经统计学分析各组之间的差异.结果:肿瘤实质ADC及实质/白质值(rADC)测量,Ⅰ～Ⅳ级肿瘤的ADC值分别为(1.30±0.35)×10-3、(1.06±0.23)× 10-3、(0.91±0.15)×10-3和(0.63±0.11)× 10-3mm2/s,rADC分别为1.69±0.49、1.32±0.28、1.20±0.29和0.79±0.19,除Ⅱ、Ⅲ级肿瘤间不存在统计学差异外,其余各组间差异均有统计学意义.Ⅰ～Ⅱ和Ⅲ～Ⅳ级组肿瘤ADC值分别为(1.24±0.34)和(0.87±0.28)× 10-3mm2/s,rADC分别为1.60±0.45和1.17±0.38,两组差异有统计学意义(P<0.05),Ⅰ～Ⅱ级组高于Ⅲ～Ⅳ级组.结论:DWI对于小儿颅内肿瘤级别的判断有一定的帮助,而ADC或rADC值,特别是后者能较为可靠地鉴别小儿常见颅内肿瘤的级别.%Objective:To evaluate the diffusion weighted MR imaging (DWI) in determining the WHO grade of intracranial tumors in children. Methods : The diffusion weighted MR imaging ( DWI) and apparent diffusion coefficient ( ADC)value of sixty cases with pathology proved intra-cranial tumors in children including grade Ⅰ (19 cases) , grade Ⅱ (17 cases),grade Ⅲ (14 cases) and grade Ⅳ (10 cases) tumors were retrospectively analyzed. The ADC values of solid part of tumor and the normal white matter were measured and the difference among the groups was statistically analyzed. Results :The ADC (rADC) values for grade Ⅰ～Ⅳ tumors were 1.30±0.35、1.06±0.23.0.91±0.15.0.63±0.11 (1.69±0.49、1.32±0.28、1.20±0.29.0.79±0.19) respectively. Apart from grade Ⅱ and grade Ⅲ with no statistical difference, there were significant differences among the rest. The ADC (rADC) values for grade Ⅰ ～ Ⅱ group and grade Ⅲ ～ Ⅳ group were 1.24±0.34、0.87±0.28 (1.60±0.45、1.17±0.38) respectively with significant statistical difference (P＜0.05). The ADC or rADC values of grade Ⅰ ～ Ⅱ group were higher than that of grade Ⅲ ～ Ⅳ group. Conclusion : DWI showed certain significance in determinating the grade of intracranial tumors in children. ADC especially rADC values are reliable in the differentiation of grade Ⅲ～Ⅳ from grade Ⅰ～Ⅱ tumors.