【摘要】 目的探讨磁共振弥散加权成像(DWI)、灌注加权成像(PWI)和1H波谱(1H-MRS)检查在单发脑转移瘤与恶性胶质瘤鉴别诊断中的应用价值。方法对术前进行了磁共振DWI、PWI和MRS检查并经病理证实的18例单发脑转移瘤和16例恶性胶质瘤进行回顾性分析,测量各病灶瘤体区、瘤周区及对照区的ADC、rCBV及Cho/Cr、Cho/NAA、NAA/Cr值,并计算rADC及rrCBV。结果瘤灶区rADCT单发脑转移瘤与恶性胶质瘤之间没有统计学差异(P>0.05),瘤周区rADCP脑转移瘤高于恶性胶质瘤,分别为1.98±0.69及1.43±0.31(P<0.05);瘤灶区rrCBVT和瘤周区rrCBVP转移瘤均低于恶性胶质瘤,分别为1.07±0.62、2.68±1.22(P<0.05)和0.38±0.23、1.11±0.61(P<0.05);瘤灶区Cho/Cr、Cho/NAA、NAA/Cr值脑转移瘤与恶性胶质瘤之间差异均无统计学意义;瘤周区胶质瘤Cho峰高于脑转移瘤,Cho/Cr和Cho/NAA值均高于脑转移瘤,分别为2.25±0.75、1.91±0.40和1.31±0.15、0.96±0.32(P<0.05和P<0.01)。结论综合分析瘤体周围区的磁共振DWI、PWI和MRS结果,对单发脑转移瘤与恶性胶质瘤的鉴别诊断有重要应用价值。更多还原

【Abstract】 Objective To explore the value of diffusion,perfusion and proton spectroscopic MR imaging in differential diagnosis of solitary metastases and high-grade gliomas. Methods 18 cases with solitary metastases and 16 cases with high-grade gliomas underwent conventional, contrast-enhanced MR imaging and DWI, PWI, MRS examinations before surgical resection or stereotactic biopsy.The ADC, rCBV, Cho/Cr, Cho/NAA, NAA/Cr values of every case in the the tumor’s region, peritumoral area and control plot (normal alba) were measured. Relative apparent diffusion coefficient(rADC), relative regional cerebral blood volume(rrCBV) were calculated. Results There were no statistically differences in the relative ADC value in the tumoral region rADCT between metastase and high-grade gliomas (P>0.05). The relative ADC value in the peritumoral area rADCP in metastases was higher than that in high-grade gliomas, 1.98±0.69 and 1.43±0.31, respectively (P<0.05).The relative regional cerebral blood volume in the tumoral region rrCBVT and peritumoral area rrCBVP in metastases were lower than that in high-grade gliomas , they were 1.07±0.62 , 2.68±1.22 (P<0.05) and 0.38±0.23,1.11±0.61 (P<0.05), respectively. There were no statistically differences in tumoral Cho/Cr,Cho/NAA and NAA/Cr between metastases and high-grade gliomas. In the peritumoral area, Cho peaks of high-grade gliomas were higher than that of metastases, and the ratios of Cho/Cr, Cho/NAA were also higher,the differences were statistically significant between them, peritumoral Cho/Cr and Cho/NAA in gliomas and metastases were 2.25±0.75,1.91±0.40 (P<0.05) and 1.31±0.15,0.96±0.32 (P<0.01), respectively. Conclusion To analyze the diffusion,perfusion and proton spectroscopic MR imaging in the peritumoral area synthetically can provide very important value for distinguishing between solitary metastases and high-grade gliomas.更多还原