【摘要】 目的探讨表观弥散系数(ADC)在脑胶质瘤术前病理分级及判断预后中的作用.方法对21例病理证实的脑胶质瘤患者行弥散加权成像及常规MR检查,对其中12例进行随访.分别测量肿瘤实质部分、肿瘤坏死囊变区、肿瘤周边区域以及对侧正常脑白质区ADC值及相对ADC值.分析镜下肿瘤标本的细胞构成.结果①肿瘤各部分ADC值从大到小依次为囊变坏死部分、瘤周水肿部分、肿瘤实质部分、正常脑白质.②胶质瘤实质部分的ADC值及rADC均与肿瘤细胞构成呈负相关(p<0.01,r=-0.739;p<0.01,r=-0.748).③低级胶质瘤(I～II级)组的平均ADC值及rADC值均高于高级胶质瘤(III～IV级)组平均ADC(p<0.01)④12例术后复查患者中5例复发组原发肿瘤瘤周区域ADC值低于7例无复发组肿瘤瘤周区域ADC值(p<0.01).结论磁共振弥散加权成像能够反映胶质瘤的细胞构成,对于低级与高级胶质瘤之间的术前鉴别有一定的参考价值.瘤周ADC值可能为评价胶质瘤的侵袭性提供一定帮助.更多还原

【Abstract】 ObjectiveTo study the role of ADC value measurement in the preoperative grading and prognosis prediction of brain gliomas. Methods21 histologiclly verified brain goliomas were studied with diffusion weighted MR imaging (DWI) and conventional MR imaging. ADC values and relative ADC(rADC) of different portions of gliomas and contralateral normal brain were measured. Cellularity of the gliomas were analized with scoin image software. Results①ADC value of the necrotic portion of gliomas was highest, followed by peritumoral edema, solid portion of tumors and normal brain.②ADC value and rADC of solid portion of gliomas correlated well with cellularity of tumors,(p<0.01,r=-0.739;p<0.01,r=-0.748).③ADC value and rADC of low grade(gradeI-II) gliomas was higher than that of high grade(grade III-IV) gliomas (p<0.01).④Peritumoral ADC value of recurrent group was lower than that of unrecurrent group (p<0.01).ConclusionsDiffusion weighted MR imaging can reflect cellularity of gliomas, as a complementary method of conventional MRI, DWI has predictive value in the preoperative evaluation of malignancy of gliomas. Peritumoral ADC value can provide useful information of aggressiveness of gliomas.更多还原