弥散张量成像对脑内囊性胶质瘤病理分级的价值

目的探讨弥散张量戍像diffusion tellsor imaging，DTI）对脑内囊性胶质瘤进行术前病理分级评估的价值。方法收集我院脑内袭性胶质瘤患者21例，按术后病理结果将其分为低级别组（I、II级）8例及高级别组（III、IV级）13例。所有研究对象术前均行磁共振常规序列及DTI序列检查，对两组患者病灶囊性部分及囊壁部分的部分各向异性指数（fractionalanisotropy，FA）及表面弥散系数（apparent diffuSiO11COefficient，ADC）进行统计分析。结果病灶囊性部分，低级别胶质瘤ADC值和FA值分别为2．89±0．10×100mm0／S、0．O78±0．04；高级别胶质瘤分别为2．53±0．25×10-3mm0／S、0．098±0．04。病灶囊壁部分，低级别胶质瘤ADc值和FA值分别为1．23±0．06×10-3mill0／S、0．17±0．O3；高级别胶质瘤分别为1．27±0．10×10-3mm0／S、O．22±0．05。病灶囊性部分ADc值及囊壁部分的FA值有统计学差异。囊壁部分ADC值以2．65x100mm0／S为阈值，诊断敏感度为93．8％，特异度为80％：囊壁部分FA值以O．19为闽值，诊断敏感度为88％，特异度为81％。结论DTI定量分析囊性JJ吏质瘤，其囊性部分ADC值及囊壁部分FA值对术前病理分级有一定预测价值。

Application Value of Diffusion Tensor Im- aging in Grading Cerebral Cystic Glioma

Objective To explore the clinical value of diffusion tensor imaging（DTI） to pathological grade of intracranial saccular glioma. Methods 21 patients with cerebral cystic glioma were studied. Base on the grade of pathology, patients were divided into low-grade glioma group （8 cases） and high-grade group （ 13 cases）. All the cases underwent conventional MR scanning and diffusion tensor imaging. Fractional anisotropy （FA） and average diffusion coefficient （ADC） values were measured in cystic and solid parts of tumor, and the differences of theses values between two groups were assessed. Result In cystic pans, the ADC and FA value of low-grade glioma were 2.89 ± 0.10 × 10-3mm-3/s and 0.078 ± 0. 04, and those of high-grade glioma were 2.53 ± 0.25 × 10-3mmZ/s and 0.098i,h,0.04. In solid parts, the ADC and FA value of low-grade gliomas were 1.23 ± 0.06 × 10-2mm-2/s and 0.17 ± 0.03, and those of high-grade glioma were 1.27± 0.10× 10-3mm2/s and 0. 22iA,0.05. There were significant differences in ADC value of cystic parts and FA value of solid pans. The threshold of ADC value in cystic parts and FA value in solid parts were 2. 65 ×10-3mm2/s and 0.19 respectively. The diagnosis sensibility was 93.8% and 88%, and the specificity were 80% and 81% respectively. Conclusion The measurement of ADC value of cystic parts and FA values ？？of the solid parts in quantitative analysis of cystic glioma by DTI has a certain predictive value in preoperative pathological grading.