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。

Value of 3.0T Diffusion Tensor Imaging in Differential Diagnosis of High-Grade Gliomas and Brain Metastases

Objective To evaluate the value of anisotropic fraction(fractional anisotropy,FA)and apparent diffusion coefficient(apparent diffusion coefficient,ADC)in 3.0 T diffusion tensor imaging parameters in differentiating high-grade gliomas from brain metastases.Methods Fifteen cases of high-grade glioma and 19 cases of brain metastases were confirmed by surgical pathology or clinical follow-up.Routine MRI scan,enhanced scan,DWI and DTI scan were performed before operation.ADC value and FA value were measured,and the difference of ADC value and FA value in different parts of tumor were compared.t test was used.Results Significant differences in FA between high-grade gliomas and brain metastases were found in the tumor parenchyma area and tumor marginal region.Significant differences in ADC values in peripheral edema areas.Conclusion Diffusion tensor imaging can be used as a differential diagnosis method for high grade gliomas and brain metastases.