摘要
目的探讨瘤(灶)周水肿的磁共振弥散加权成像(DWI)表现在脑肿瘤诊断方面的临床应用价值。方法对73例脑肿瘤(胶质瘤40例,转移瘤20例,脑膜瘤13例)、3例脑脓肿及2例炎性肉芽肿患者进行常规MRI及DWI检查。对照测量病变的实质部分、周围水肿区以及正常脑组织的表观弥散系数(ADC)值,并分析实质部分及水肿区的相对ADC值(rADC)。对于瘤周水肿直径>1cm者,将水肿区域划分为近侧、远侧瘤周。结果高级别胶质瘤与低级别胶质瘤、转移瘤、脑膜瘤、炎性病变之间的近侧瘤(灶)周水肿rADC值存在差异。各病变远侧水肿区之间的rADC值无差别。高级别胶质瘤的近侧瘤周水肿区rADC值低于远侧;低级别胶质瘤近、远侧瘤周水肿的rADC不能区分;转移瘤、脑膜瘤、炎性病变近侧瘤(灶)周水肿区rADC值高于远侧。结论脑肿瘤近侧水肿区DWI检查的rADC值有助于胶质瘤级别鉴定和与其他肿瘤及炎性病变的鉴别。高级别胶质瘤近侧瘤周水肿区rADC值低于远侧,而在低级别胶质瘤、转移瘤、脑膜瘤和炎性病变却相反。
Objective To evaluate the value of diffusion-weighted imaging （DWI） in the diagnosis of intracranial tumors by analyzing the parameters obtained from peritumoral edema. Methods Seventy-eight patients with brain diseases （73 brain tumors, 3 brain abscesses, 2 inflammatory granulomas） underwent routine, diffusion-weighted MR imaging. Comparisons of relative apparent diffusion coefficient （rADC） were done among peritumoral edematous and tumoral tissues. The peritumoral signal abnormality was divided into two regions to allow investigation of whether rADC varies with distance from the enhancing portion of the tumor. Results rADC of immediate perifocal edema were significantly different among high-grade gliomas, low-grade gliomas, metastases, meningiomas and inflammation, while no significantly difference was recorded among rADC in distant peripheral edema of all diseases. As for high-grade glioma, the rADC of immediate peritumoral edema was lower than that of distant edema. The rADC in immediate and distant peritumoral edema of low-grade glioma could not be distinguished from each other. The rADC of immediate peripheral edema in patients with metastases, meningiomas or inflammatory diseases differed significantly from those of distant peripheral edema. Conclusion Using DWI, the rADC of immediate peritumoral edema was helpful in grading glioma and differentiating glioma from other brain tumors and inflammatory diseases. The rADC of immediate peritumoral edema is lower than that of distant edema in high-grade glioma, which is contrary to low-grade glioma, metastasis, meningioma and inflammatory disease. The rADC of immediate peritumoral edema was helpful to grade diagnosis of glioma.
出处
《中国医学影像技术》
CSCD
北大核心
2005年第12期1810-1814,共5页
Chinese Journal of Medical Imaging Technology
关键词
脑肿瘤
瘤周水肿
磁共振成像
弥散加权成像
Brain tumor, Peritumoral edema
Magnetic resonance imaging, Diffusion-weighted imaging
作者简介
张竞文（1980-）,女,辽宁大连人,硕士,医师.研究方向：神经系统影像诊断.E-mail：zhangqingsmile@163.com
[通讯作者]伍建林,大连医科大学附属第一医院放射科,116011.E-mail：cjr.wujianlin@vip.163.com
