DWI对颅底脊索瘤与软骨肉瘤鉴别诊断的应用价值

目的 探讨扩散加权成像(DWI)在颅底脊索瘤与颅底软骨肉瘤鉴别诊断中的应用价值.方法 回顾性分析经病理证实的14例经典型颅底脊索瘤、9例未分化型颅底脊索瘤及18例软骨肉瘤的临床及影像学资料.分析瘤体组织的部位、T2WI相对灰质的信号、强化方式及表观扩散系数(ADC).增强扫描未见强化记为0分,不均匀强化为1分,90％以上瘤体均匀强化为2分.采用非参数检验进行统计.结果 3种肿瘤病灶的平均ADC值、最小ADC值、最大ADC值及T2 WI信号强度均存在显著差异(P＜o.05).瘤体的强化方式在病例数量方面存在显著差异(P＜0.05),但强化方式的得分及发病部位无显著差异(P＞0.05).结论 DWI对颅底肿瘤的鉴别诊断具有重要的临床价值,结合T2 WI信号可提高颅底肿瘤的诊断率.

The value of DWI in the differential diagnosis between chordoma and chondrosarcoma in skull base

Objective To explore the application value of diffusion-weighted imaging(DWI) in distinction of skull base chordoma from chondrosarcoma.Methods The clinical data and imaging findings of basicranial tumor confirmed by pathology,including 14 patients with classic chordoma,9 with poorly differentiated chordoma and 18 with chondrosarcoma were analyzed retrospectively.The lesion location,enhancement patterns,signal intensity on T2 WI relative to gray matter,and apparent diffusion coefficient (ADC) values were reviewed.The enhancement pattern was scored as 0 (little or non-enhancement),1 (heterogeneous enhancement),or 2 (homogeneous enhancement in ≥90％area).The data were analysed by Kruskal-Wallis test.Results There were significant differences in the mean,minimum and maximum ADC values,the intensity on T2 WI and the enhancement pattern among the three tumor types (P ＜0.05).However,the differences in the score of enhancement pattern and lesion location were not found (P＞0.05).Conclusion DWI may be helpful for the diagnosis of skull base chordoma from chondrosarcoma,and the accuracy rate will be improved when combined with T2WI intensity.