摘要
目的探讨扩散加权成像（DWI）和表观扩散系数（ADC）在诊断及鉴别诊断鞍区恶性生殖细胞肿瘤与颅咽管瘤的价值。方法回顾性分析郑州大学第一附属医院2013年1月至2017年4月经病理证实的治疗前行常规MRI平扫和DWI检查的36例鞍区病变患者的临床资料，其中恶性生殖细胞肿瘤14例，颅咽管瘤22例，测量比较两种病变的ADC均值。运用受试者工作特征（ROC）曲线评价ADC值的诊断价值。结果恶性生殖细胞肿瘤平均ADC值为（0．93±0．23）×10^-3mm^2／s，颅咽管瘤平均ADC值为（1．69±0．21）×10^-3mm^2／s，前者明显低于后者（t=-10．19，P〈0．01）。ADC值诊断鞍区恶性生殖细胞肿瘤与颅咽管瘤的ROC曲线下面积为0．987，以ADC值1．52×10^13mm^2／s为阈值时，与病理结果对照，判断恶性生殖细胞肿瘤与颅咽管瘤的敏感度为81．8％，特异度为100％，准确度为88．9％，与病理结果行一致性检验，Kappa值为0．887。结论鞍区恶性生殖细胞肿瘤与颅咽管瘤具有不同扩散特征，ADC值对于两者之间的鉴别诊断具有重要参考价值，可提高诊断准确率。
Objective To investigate the diagnostic value of diffusion-weighted imaging （DWI） and apparent diffusion coefficient （ADC） values in the differentiation of sellar malignant germ cell tumors and raniopharyngioma. Methods This retrospective study included 36 patients（ 14 cases of malignant germ cell tumor and 22 patients with raniopharyngioma） with histopathologieally-confirmed sellar tumors from January 2013 to April 2017 in the First Affiliated Hospital of Zhengzhou University. All patients underwent conventional MRI and DWI before the treatment. ADC maps were reconstructed, and ADC values of the sellar lesions were calculated and compared between the groups. Diagnostic value of ADC was evaluated by receiver operating characteristic （ ROC ） curves. Results The mean ADC values of malignant germ cell tumors were significantly lower than that in raniopharyngioma [ （0. 93 ± 0. 23 ） × 10^-3 mm^2/s vs （ 1.69 ± 0. 21 ）×10^-3 mm^2/s, t = - 10. 19, P 〈0. 01 ]. The area under the ROC curves of ADC values diagnosing malignant germ cell tumors and raniopharyngioma was 0. 987. The optimal cutoff values of ADC for differential diagnosis of malignant germ cell tumors and raniopharyngioma was 1.52 × 10^-3 mm^2/s, the sensitivity, specificity and accuracy was 81.2%, 100%, 88. 9%, respectively. ADC value had a high consistency with pathological results （ Kappa value was 0. 887 ）. Conclusion Malignant germ cell tumors and raniopharyngioma have different ADC value, which can improve the diagnostic accuracy.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2017年第37期2903-2907,共5页
National Medical Journal of China
关键词
颅咽管瘤
恶性生殖细胞肿瘤
鞍区
扩散加权成像
表观扩散系数
Raniopharyngioma
Malignant germ cell tumors
Sellar
Diffusion-weighted imaging
Apparent diffusion coefficient
作者简介
通信作者：程敬亮，Email：cjr．chjl@vip．163．com
