弥散张量成像在高级别胶质瘤与转移瘤中的鉴别诊断价值初探

目的 探讨弥散张量成像(DTI)在高级别胶质瘤与转移瘤中的鉴别诊断价值.方法 收集经手术病理证实13例高级别胶质瘤与13例转移瘤,均做了磁共振DTI,获得平均弥散系数(MD)图及部分各向异性指数(FA)图,分别测定2组肿瘤实质区、囊变坏死区、瘤周区及正常白质区MD值、FA值,分析比较2组肿瘤实质区、囊变坏死区、瘤周区MD值、FA值有无统计学差异.结果 胶质瘤肿瘤实质区、囊变坏死区、瘤周区MD值分别为(0.976±0.171)×10-9mm2/s、(1.92±0.515)×10-9mm2/s、(1.41±0.288)×10-9mm2/s,转移瘤上述3个区MD值分别为(1.12±0.364)×10-9mm2/s、(1.72±0.646)×10-9mm2/s、(1.66±0.164)×10-9mm2/s,2组肿瘤实质区、囊变坏死区MD值比较无统计学差异(P>0.05),胶质瘤瘤周区MD值低于转移瘤(P<0.05);胶质瘤肿瘤实质区、囊变坏死区、瘤周区FA值分别为0.137±0.056、0.084±0.061、0.148±0.090,转移瘤上述3个区FA值分别为0.140±0.0778、0.0702±0.0265、0.126±0.0567,2组肿瘤实质区、囊变坏死区、瘤周区FA值比较均无统计学差异(P>0.05).结论 通过测定瘤周区MD值,DTI有助于高级别胶质瘤与转移瘤的鉴别诊断.     

弥散峰度成像对高级别脑胶质瘤和单发脑转移瘤的鉴别价值研究

目的 探讨弥散峰度成像(DKI)对鉴别高级别脑胶质瘤和单发脑转移瘤的临床应用价值.方法 搜集经病理或临床证实的33例脑肿瘤患者纳入研究,其中高级别胶质瘤18例,单发脑转移瘤15例,分别行常规磁共振平扫、DKI及常规增强扫描.经后处理分别得到DKI相关参量图,分别测量在肿瘤实性部分、瘤周水肿区域的各参数值.采用两样本t检验,分析高级别脑胶质瘤与单发脑转移瘤实质部分和瘤周水肿区域的各相对参数值平均弥散峰度(MK)、部分各向异性(FA)、平均扩散系数(MD),分析差异有无统计学意义.结果 在肿瘤实质部分,高级别脑胶质瘤和单发脑转移瘤MK、FA、MD各相对参数值比较,差异均无统计学意义(P值分别为0.529、0.645、0.84).在瘤周水肿区域,高级别胶质瘤和单发脑转移瘤MK、FA、MD各相对参数值比较,差异均有统计学意义(P值分别为0.002、0.003、0.04).结论 (1)DKI各相对参数MK、FA、MD在肿瘤实质部分对鉴别高级别脑胶质瘤和单发脑转移瘤没有明显价值.(2) DKI各相对参数MK、FA、MD在瘤周水肿区域对高级别脑胶质瘤和单发脑转移瘤有鉴别诊断价值.     

3.0T磁共振扩散张量成像对高级别脑胶质瘤和脑转移瘤的鉴别诊断价值

目的探讨3.0T磁共振扩散张量成像参数中的各向异性分数(FA)值、表观扩散系数(ADC)值对高级别脑胶质瘤和脑转移瘤的鉴别诊断价值。方法分析经手术病理或临床随访证实15例高级别脑胶质瘤和19例脑转移瘤,术前行常规MRI扫描、增强扫描、DWI及DTI扫描,选取感兴趣区(肿瘤囊变区、肿瘤实质区、肿瘤边缘区、瘤周水肿区、肿瘤周围正常脑实质区),分别测量其ADC值及FA值,比较两种肿瘤不同部位ADC值及FA值的差异,采用t检验。结果高级别脑胶质瘤与脑转移瘤的肿瘤实质区(t=4.09,P=0.001)、肿瘤边缘区(t=3.34,P=0.002)的FA值差异显著(P<0.05)。两种肿瘤周围水肿区(t=4.79,P=0.000)的ADC值差异显著(P<0.05)。结论扩散张量成像可以作为高级别脑胶质瘤和脑转移瘤的鉴别诊断方法。     

DWI在胶质瘤与单发转移瘤及其瘤周水肿中的诊断价值

目的:探讨DWI在颅内肿瘤及其瘤周水肿中的诊断价值和病理生理机制。材料和方法:分析ADC值在高级别胶质瘤和颅内单发转移瘤的病灶实质及水肿带中的改变(36例)。感兴趣区取病灶实质部分(病灶强化部分)及病灶周围水肿带(将水肿带三等份,分别作为近瘤周区、居中及远瘤周区水肿带),分别测定前述感兴趣区ADC值,测定对侧正常颞叶脑皮质ADC值作为参照值,测定相对ADC值(rADC值)作为分析指标。结果:转移瘤病灶实质及水肿带的ADC值均高于胶质瘤,即在DWI图上前者与后者相比为稍低信号,两者水肿带间ADC值有显著差异。胶质瘤居中水肿带ADC值最低,低于近瘤周区及远瘤周区水肿带,有统计学差异。转移瘤居中水肿带ADC值稍低于近瘤周区及远瘤周区水肿带,但无统计学差异。结论:转移瘤病灶实质及水肿带ADC值均高于胶质瘤。胶质瘤水肿带成因除血管源性水肿之外,尚有部分原因为瘤细胞的浸润所致,肿瘤细胞阻碍了水分子的运动,此点有助于术前在DWI上鉴别两种肿瘤。     

MRS联合多b值DWI对高级别胶质瘤与单发脑转移瘤的鉴别诊断价值

【摘要】目的：探讨氢质子磁共振波谱（1H-MRS）联合多b值磁共振扩散加权成像（DWI）的多参数值对术前幕上单发大脑高级别胶质瘤（HGG）与单发脑转移瘤（MET）的鉴别诊断价值。方法：选取术前常规MRI检查考虑为幕上单发的HGG或MET的住院患者,对其进行1H-MRS及多b值DWI成像,利用后处理软件重建波谱图及各b值对应的ADC图,分别于各肿瘤瘤体区、瘤周区及对应正常脑质的合适层面勾画兴趣区（ROI）,分别记录其平均Cho/NAA值、Cho/Cr值、 NAA/Cr值及ADC值,最终满足纳入标准的有49例（经手术病理或临床随访证实HGG 24例,MET 25例）。采用独立样本t检验（正态分布）或Mann-Whitney U检验（非正态分布）比较两组间各参数差异性,绘制受试者操作特征（ROC）曲线分析各参数鉴别HGG与MET的诊断效能。利用二元logistic回归分析得到两种技术联合鉴别HGG与MET的预测概率,然后绘制ROC曲线分析MRS、多b值DWI及两种技术联合三种方法鉴别两种肿瘤的诊断效能。结果：瘤周区平均Cho/Cr值为MRS鉴别两者的最佳参数,其曲线下面积（AUC）为0.936,敏感度为90%,特异度为87%。当b=1000s/mm2时相应的瘤周区ADC值为DWI鉴别两者的最佳参数,其AUC为0.863,敏感度为87%,特异度为78.9%。联合两种技术的最佳鉴别参数,即瘤周区平均Cho/Cr值和b=1000s/mm2时相应的瘤周区ADC值,绘制ROC曲线分析MRS、高b值ADC值及两种技术联合鉴别两者的诊断效能,发现两种技术联合时AUC最大,为0.973,敏感度为86.4%,特异度为100%。结论：1H-MRS联合多b值DWI对两种肿瘤的鉴别诊断效能优于其中任一成像技术的鉴别诊断效能。     

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。     

基于三维密集连接卷积网络鉴别高级别胶质瘤与单发脑转移瘤

目的 探讨三维密集连接卷积网络（3D-DenseNet）通过MRI鉴别诊断高级别胶质瘤（HGGs）与单发脑转移瘤（BMs的价值,并比较不同序列建立的模型诊断性能。资料与方法 回顾性收集兰州大学第二医院2016年6月—2021年6月经手术病理证实的230例HGGs和111例BMs的T2WI及T1WI对比增强（T1C）影像资料,预先勾画出三维模型下的感兴趣区体积作为输入数据,以7:3随机分为训练集254例和验证集87例,基于3D-DenseNet分别构建T2WI、T1C及两种序列融合的预测模型（T2-net、T1C-net和TS-net）,通过受试者工作特征曲线评价各模型的预测效能并进行比较。结果 T1C-net、T2-net和TS-net在训练集和验证集的曲线下面积（AUC）分别为0.852、0.853,0.802、0.721,0.856、0.745。T1C-net在验证集的AUC及准确度高于T2-net和TS-net,TS-net在验证集的AUC及准确度高于T2-net,T1C-net与T2-net在验证集的AUC差异有统计学意义（P<0.05）,而TS-net与T2-net、T...     

MR FLAIR序列在鉴别高级别胶质瘤与脑单发转移瘤中的价值

目的 探讨MR液体衰减反转恢复序列(FLAIR)图像上强化边缘外邻近皮层异常信号在鉴别高级别胶质瘤和单发转移瘤中的作用和价值;评价此征象对高、中、低3个年资的神经放射科医师诊断胶质瘤的作用和价值.资料与方法 对42例高级别胶质瘤和12例脑单发转移瘤患者做MRI时加扫FLAIR序列.42例高级别胶质瘤中,男28例,女14例,年龄15～76岁,平均48.8岁.13例单发转移瘤中,男7例,女6例,年龄37～73岁,平均57.6岁.分析上述病例的FLAIR及T2WI图像上强化边缘外邻近皮层异常信号征象,进行χ2检验,并在高、中、低3个年资各两名神经放射科医师前后两次读片后进行接受者操作特性(ROC)曲线分析,并应用Z检验对前、后两次ROC曲线下面积进行差异性检验.结果 29例的FLAIR图像上存在强化边缘外邻近皮层异常信号,胶质瘤27例,转移瘤2例,这一征象在高级别胶质瘤组和单发转移瘤组显示的差异具有统计学意义(P=0.002＜0.05).T2WI强化边缘外邻近皮层异常信号征象在胶质瘤组和转移瘤组显示的差异亦具有统计学意义(P=0.003＜0.05).前后两次阅片的总体ROC曲线、每一年资及每位医师前后两次阅片的ROC曲线下面积的差异均无统计学意义(P＞0.05).五名医师的胶质瘤诊断准确率均有所提高,以低年资为著.结论 FLAIR强化边缘外邻近皮层异常信号有助于高级别胶质瘤和转移瘤的鉴别诊断.在无FLAIR图像的情况下,T2WI可作为显示此征象的替代方法 .     

MR弥散、灌注、波谱成像在单发脑转移瘤与恶性胶质瘤鉴别诊断中的价值

目的探讨磁共振弥散加权成像(DWI)、灌注加权成像(PWI)和1H波谱(1H-MRS)检查在单发脑转移瘤与恶性胶质瘤鉴别诊断中的应用价值。方法对术前进行了磁共振DWI、PWI和MRS检查并经病理证实的18例单发脑转移瘤和16例恶性胶质瘤进行回顾性分析,测量各病灶瘤体区、瘤周区及对照区的ADC、rCBV及Cho/Cr、Cho/NAA、NAA/Cr值,并计算rADC及rrCBV。结果瘤灶区rADCT单发脑转移瘤与恶性胶质瘤之间没有统计学差异(P>0.05),瘤周区rADCP脑转移瘤高于恶性胶质瘤,分别为1.98±0.69及1.43±0.31(P<0.05);瘤灶区rrCBVT和瘤周区rrCBVP转移瘤均低于恶性胶质瘤,分别为1.07±0.62、2.68±1.22(P<0.05)和0.38±0.23、1.11±0.61(P<0.05);瘤灶区Cho/Cr、Cho/NAA、NAA/Cr值脑转移瘤与恶性胶质瘤之间差异均无统计学意义;瘤周区胶质瘤Cho峰高于脑转移瘤,Cho/Cr和Cho/NAA值均高于脑转移瘤,分别为2.25±0.75、1.91±0.40和1.31±0.15、0.96±0.32(P<0.05和P<0.0...     

脑胶质瘤磁共振扩散张量成像与病理对照研究

目的 探讨脑胶质瘤病理良恶性分级与磁共振扩散张量成像(diffusion tensor imaging, DTI)的相关性.方法 搜集本院脑胶质瘤手术病人32例,该组患者术前均进行了完整的磁共振常规检查及DTI扫描,对于每一例患者分别于瘤中心、瘤边缘、正常区域脑白质3个位置测各项指标部分各向异性(FA)值、ADC值,每一病人每一部位测3次.搜集其病理分级、Ki67增殖指数等病理结果,并与DTI各项值进行相关分析.结果 瘤中心、瘤边缘、周围正常组织各部位FA值、ADC值均存在着显著差异,不同级别肿瘤的瘤中心FA值(后简称FA值)有显著性差别,且FA值与肿瘤分级呈正相关,FA值与Ki67增殖指数呈现明显正相关,且Ki67增殖指数与肿瘤分级呈正相关,而ADC值与Ki67、肿瘤分级之间均无相关性.结论 DTI检查,尤其是FA值对脑胶质瘤良恶性分级评估具有一定价值.     

磁共振弥散张量成像在脑高级别星形细胞瘤和转移瘤瘤周实质区的诊断价值

目的 探讨磁共振弥散张量成像(diffusion tensor imaging,DTI)在高级别星形细胞瘤和单发脑转移瘤诊断中的价值.方法 25例脑高级别星形细胞瘤和16例单发脑转移瘤,术前行DTI扫描,测定瘤周脑实质区及对侧正常脑实质的平均弥散系数(MD)值及各向异性分数(FA)值,并重建白质纤维示踪图,观察病灶与白质纤维束的关系.结果 高级别星形细胞瘤与脑转移瘤瘤周实质区的FA值分别为0.227±0.05、0.169±0.07,两者存在统计学差异(P＜0.05).DTI白质纤维示踪图可以较为准确地反映病灶与白质纤维束的关系.结论瘤周实质区FA值有助于高级别脑星形细胞瘤与转移瘤的鉴别.     

Diagnostic Utility of Diffusion Tensor Imaging in Differentiating Glioblastomas from Brain Metastases

BACKGROUND AND PURPOSE:Differentiation of glioblastomas and solitary brain metastases is an important clinical problem because the treatment strategy can differ significantly. The purpose of this study was to investigate the potential added value of DTI metrics in differentiating glioblastomas from brain metastases.MATERIALS AND METHODS:One hundred twenty-eight patients with glioblastomas and 93 with brain metastases were retrospectively identified. Fractional anisotropy and mean diffusivity values were measured from the enhancing and peritumoral regions of the tumor. Two experienced neuroradiologists independently rated all cases by using conventional MR imaging and DTI. The diagnostic performances of the 2 raters and a DTI-based model were assessed individually and combined.RESULTS:The fractional anisotropy values from the enhancing region of glioblastomas were significantly higher than those of brain metastases (P < .01). There was no difference in mean diffusivity between the 2 tumor types. A classification model based on fractional anisotropy and mean diffusivity from the enhancing regions differentiated glioblastomas from brain metastases with an area under the receiver operating characteristic curve of 0.86, close to those obtained by 2 neuroradiologists using routine clinical images and DTI parameter maps (area under the curve = 0.90 and 0.85). The areas under the curve of the 2 radiologists were further improved to 0.96 and 0.93 by the addition of the DTI classification model.CONCLUSIONS:Classification models based on fractional anisotropy and mean diffusivity from the enhancing regions of the tumor can improve diagnostic performance in differentiating glioblastomas from brain metastases.

Differentiation of glioblastomas and solitary brain metastases is an important clinical problem because the treatment strategy can significantly differ depending on the tumor type.^1,2 In some cases, clinical history and/or multiplicity of enhancing brain lesions makes the diagnosis of brain metastases relatively straightforward. However, a solitary brain metastasis on MR imaging can have a nonspecific appearance. Similarly confounding the issue is the fact that glioblastomas can also occasionally present as multiple enhancing lesions. Moreover, although a glioblastoma typically presents as a solitary mass, a solitary brain metastasis may be the first manifestation of disease in approximately 30% of patients with systemic cancer.³ Hence, accurate distinction between glioblastomas and brain metastases can be challenging, often necessitating an invasive surgical biopsy for a definitive diagnosis.DTI has been used to differentiate glioblastomas from brain metastases, but with conflicting results. Some reports have suggested that mean diffusivity (MD)^4–6 is helpful for the differentiation, while others indicated the limited use of MD in the differentiation of neoplasms.^7–9 Wang et al¹⁰ and Reiche et al¹¹ reported lower fractional anisotropy (FA) from the enhancing regions (ERs) of glioblastomas compared with brain metastases. In contrast, another study reported that glioblastomas have higher FA in the enhancing regions than metastases.¹² The potential reasons for these conflicting results may include differences in analysis methods, particularly in defining the region of interest, as well as the relatively small size of cohorts used in individual studies (n = 24–66).^4,5,7,10,13 Hence, a primary objective of this study was to investigate the DTI characteristics of glioblastomas and brain metastases in a substantially larger cohort of patients, in order to determine whether they may have diagnostic utility.Restricted water diffusion in solid tumors has been reported by many groups.^7,14–17 It is generally assumed that a solid tumor does not have any microstructural orientation by itself and its growth induces structural disorder in the tissue, which leads to decreased FA.¹⁸ However, although the association between FA and tumor cellularity has been studied, the relationship remains unclear because both positive^12,14,19 and negative¹⁶ correlations have been reported. Our previous study¹² showing higher FA in glioblastomas than in brain metastases also found a negative linear trend between FA and MD in glioblastomas, which was not seen in metastases, perhaps indicating a tumor-dependent relationship between these 2 parameters. While promising results with DTI have been published in the diagnosis of brain tumors, to date, its clinical value in improving the diagnostic accuracy of radiologists has not been evaluated.Hence, the objectives of the present study were to investigate the potential of DTI in differentiation of glioblastomas from solitary brain metastases in a relatively large cohort of 221 patients and to compare its diagnostic accuracy in comparison with that of 2 experienced neuroradiologists.     

Cho/Cr-n相对值测定在脑脓肿与坏死囊性变胶质瘤和脑转移瘤鉴别诊断中的价值

目的运用多体素2D1HMRS,探讨胆碱复合物/对侧相应正常脑白质区肌酸(Cho/Cr-n)相对值测定在脑脓肿与坏死囊性变胶质瘤和脑转移瘤鉴别诊断中的价值。资料与方法对经手术病理证实的12例脑脓肿与20例坏死囊性变胶质瘤和脑转移瘤患者,在术前行常规MRI检查及2D1HMRS,测量感兴趣区(ROI)的胆碱(Cho)和肌酸(Cr)相对值,并计算Cho/Cr-n相对值。结果脑脓肿的Cho/Cr-n相对值(1.12±0.25)明显低于坏死囊性变胶质瘤和脑转移瘤的上述指标(2.76±0.73和2.59±0.47)(P<0.01)。结论多体素2D1HMRS的Cho/Cr-n相对值测定在脑脓肿与坏死囊性变胶质瘤和脑转移瘤鉴别诊断中具有重要价值。     

MR-DTI在肝硬化早期诊断中的应用价值

目的 探讨磁共振扩散张量成像(diffusion tensor imaging, DTI)在诊断早期肝硬化及评估肝硬化患者临床状态的价值. 方法本研究纳入50例正常对照者(年龄为35.2岁±14.2岁,男28例,女22例)及37例肝硬化患者(年龄为41.1岁±13.0岁,男22例,女15例).其肝硬化分级资料为:Child A 17例(年龄为35.0岁±11.8岁,男14例,女3例)、Child B 12例(年龄为44.7岁±14.0岁,男5例,女7例)、Child C 8例(年龄为48.7岁±7.6岁,男3例,女5例).弥散张量成像采集采用GE Propeller HD 1.5T磁共振仪,单次激发平面回波序列.采集数据用AW4.2工作站Functool 软件进行处理.处理过程中兴趣区的选择避开胆管、血管分别于肝右叶和左叶各选取1个测量平均表观扩散系数(average diffusion coefficient ,DCave)和部分各向异性(fractional anisotropy, FA)值.采用SPSS 13.0统计软件进行统计分析,当P<0.05时,认为差异有统计学意义.结果正常对照组肝脏DCave值[(1.54±0.25)×10~(-9) mm~2 /s]高于病例组[(1.08±0.32)×10~(-9) mm~2 /s],FA值(0.46±0.10)低于病例组(0.53±0.13),均具有统计学意义(P<0.05).病例组中DCave值随Child-Pugh分级的增加而减低,在对照组、Child A、Child B及Child C 4组中DCave值分别为(1.54±0.25)×10~(-9) mm~2 /s,(1.33±0.18)×10~(-9) mm~2 /s,(1.02±0.12)×10-9 mm2 /s及(0.66±0.27)×10~(-90 mm~2 /s, FA值则先降低再增高,各组间差异具有统计学意义(P<0.05);在对照组、Child A、Child B及Child C 4组中FA值分别为0.46±0.10,0.42±0.08, 0.56±0.05及0.71±0.41,其中对照组与Child A组之间差异不具统计学意义(P=0.54),其余各组间差异具有统计学意义(P<0.05).结论 MR-DTI是一种检查肝硬化病变的敏感手段.     

扩散加权成像在鉴别颅内环形强化病灶的价值

目的讨论扩散加权成像(DWI)和表观扩散系数(ADC)在鉴别颅内环形强化病灶性质的价值。资料与方法应用1.5TMR对16例胶质瘤、6例转移瘤、4例脑脓肿进行常规MR及DWI成像和ADC测量,分析其影像学表现。结果4例脑脓肿在DWI上呈高信号,16例胶质瘤和6例转移瘤呈低信号,脓肿腔平均ADC值为0.44×10-3cm2/s,脑肿瘤坏死囊变区平均ADC值为1.82×10-3cm2/s(P<0.01)。结论DWI和ADC值可以用来鉴别脑脓肿及坏死囊变的肿瘤病灶。     

高级别星形细胞瘤扩散张量成像应用研究

目的 :研究平均扩散系数 (ADC)和各向异性分数 (FA)在鉴别高级别星形细胞瘤肿瘤组织、水肿及正常脑组织中的价值。方法 :16例高级别星形细胞瘤在治疗前行常规MRI及扩散张量成像 (DTI)。在T1WI增强、T2 WI及FA图上确定肿瘤、水肿及邻近正常白质区 ,测量并分析这些区域FA值及ADC值的差异。结果 :在ADC图上 ,肿瘤实体区与正常脑实质相比 ,几乎呈等信号 ;水肿区呈稍高信号 ;肿瘤囊变坏死区呈高信号。在FA图上 ,囊变坏死区呈低信号 ;肿瘤区呈等信号及低信号 ;水肿区呈等信号及稍高信号。肿瘤囊变坏死区ADC值 (2 .16± 0 .14 7)× 10 -3 mm2 /s ,水肿区 (1.5 5± 0 .0 66)× 10 -3 mm2 /s ,肿瘤实体区 (1.3 3± 0 .0 8)× 10 -3 mm2 /s ,邻近正常白质区 (0 .76± 0 .0 5 7)× 10 -3 mm2 /s。邻近正常白质区FA值最高 (0 .45± 0 .0 3 7) ,肿瘤囊变坏死区最低 (0 .0 5± 0 .0 12 )。所有患者肿瘤实体区与水肿区、正常白质区ADC值的差别均具有显著性意义 (P <0 .0 5 )。所有患者肿瘤实体区、水肿区与正常白质区FA值差异有显著性意义 (P <0 .0 5 ) ,肿瘤实体区与水肿区FA值差异无显著性意义 (P >0 .0 5 )。结论 :ADC值可用于区分正常脑白质、水肿和肿瘤实体区 ,FA值对于组织学鉴别无明显意义。ADC值、FA值能否确定