瘤周水肿区ADC值在恶性胶质瘤及脑转移瘤鉴别诊断中的价值

目的]探讨MR扩散加权成像（DWI）瘤周水肿区表观扩散系数（ADC）值在恶性胶质瘤及脑转移瘤鉴别诊断中的价值。方法]32例恶性胶质瘤（≥Ⅲ级）和24例脑转移瘤患者进行常规MRI扫描和DWI检查。分析比较两者肿瘤的边缘特征及瘤周近、远侧水肿带的表观扩散系数（ADC）和相对表观扩散系数（rADC）。结果]恶性胶质瘤近瘤水肿带的ADC值及rADC值分别为1.44×10-3±0.15×10-3mm2/s和2.01±0.24,远瘤水肿带分别为1.81×10-3±0.21×10-3mm2/s和2.49±0.33。脑转移瘤近瘤水肿带的ADC值及rADC值分别为1.70×10-3±0.22×10-3mm2/s和2.43±0.44,远瘤水肿带分别为1.81×10-3±0.18×10-3mm2/s和2.54±0.41。恶性胶质瘤和脑转移瘤近瘤水肿带的ADC值和rADC值之间的差异有统计学意义（P〈0.01）,而远瘤水肿带间的差异无统计学意义（P〉0.05）;恶性胶质瘤近、远瘤水肿带的ADC值和rADC值之间的差异有统计学意义（P〈0.01）;脑转移瘤近、远瘤水肿带的ADC值和rADC值之间的差异无统计学意义（P〉0.05）。结论]在DWI上,恶性胶质瘤和脑转移瘤的边缘特征以及瘤周近、远侧水肿带的ADC值及rADC值的差异对两者的鉴别诊断具有重要价值。

The Value of Apparent Diffusion Coefficient in the Differentiation between Peritumoral Edema of Malignant Glioma and Brain Metastasis

Purpose] To investigate the value of MR diffusion-weighted imaging(DWI)apparent diffusion coefficient(ADC)in the differentiation between peritumoral edema of malignant glioma and brain metastatic tumor.Methods] MR diffusion-weighted imaging was performed preoperatively in 32 cases with malignant gliomas(≥Ⅲstage)and 24 cases with brain metastasis.Furthermore,The ADC and relative ADC(rADC)values in the peri and distant peritumoral edema of malignant glioma and brain metastasis were analyzed.Results] The ADC and rADC values in the peri peritumoral edema of malignant glioma were 1.44×10-3±0.15×10-3mm2/s and 2.01±0.24 respectively,while in the distant peritumoral edema were 1.81×10-3±0.21×10-3mm2/s and 2.49±0.33.The ADC and rADC values in the peri peritumoral edema of the brain metastasis were 1.70×10-3±0.22×10-3mm2/s and 2.43±0.44 respectively,while in the distant peritumoral edema were 1.81×10-3±0.18×10-3mm2/s and 2.54±0.41.There was a significant difference between the ADC and rADC values in the peri peritumoral edema(P<0.01),and no significant difference in the distant peritumoral edema(P>0.05).There was a significant difference between the ADC or rADC in the peri and distant peritumoral edema of the malignant glioma(P<0.01).There was no significant difference between the ADC or rADC in the peri and distant peritumoral edema of the brain metastasis(P>0.05).Conclusions] The ADC and rADC in the peri and distant peritumoral edema in DWI and the edge features play an important role in the differentiation between malignant glioma and brain metastatic tumor.