纹理分析在原发性脑淋巴瘤与高级别胶质瘤鉴别诊断中的应用价值

发布时间：2018-05-02 04:25

本文选题：原发性脑淋巴瘤 + 高级别胶质瘤　；参考：《临床放射学杂志》2017年09期

【摘要】：目的探讨MRI图像纹理分析对鉴别原发性脑淋巴瘤与高级别胶质瘤(HGG)的临床应用价值。方法回顾性分析经病理证实的15例原发性脑淋巴瘤与18例HGG患者的MRI表现,并对T1WI增强图像进行纹理分析,分别得到熵值、偏度、峰度及异质性等相关参数。结果原发性脑淋巴瘤好发于深部脑组织,如胼胝体区、额叶及基底节区,在MRI表现为T1WI呈等、低信号,T2WI呈等、稍高信号,边界较清,增强后多呈均匀明显强化;HGG在MRI表现为T1WI呈低信号,T2WI呈高信号,增强扫描后呈明显不均匀强化,病灶内部多伴有囊变、坏死及出血成分。原发性脑淋巴瘤与HGG比较,多发病灶、强化方式和累及中线特征在统计学上存在显著差异(P0.05);纹理分析脑淋巴瘤组和HGG组中T1WI增强图像,脑淋巴瘤组的熵值与异质性参数低于HGG组的熵值与异质性参数,两者在统计学上存在显著差异(P0.05)。同时,纹理分析异质性参数明显优于熵值;当异质性参数Cut-off点取0.175时,鉴别诊断脑淋巴瘤与HGG的敏感性、特异性和准确性分为86.7%、94.4%和90.9%。结论纹理分析的熵值、异质性参数结合常规MRI平扫和增强表现,对鉴别原发性脑淋巴瘤与HGG具有一定的临床应用价值。
[Abstract]:Objective to evaluate the clinical value of MRI texture analysis in differentiating primary brain lymphoma from high grade glioma. Methods the MRI findings of 15 cases of primary brain lymphoma and 18 cases of HGG were analyzed retrospectively. The entropy, deviation, kurtosis and heterogeneity were obtained by texture analysis of T1WI enhanced images. Results Primary brain lymphoma was found in deep brain tissues, such as corpus callosum, frontal lobe and basal ganglia. On MRI, T1WI was isotropic, hypointensity was isobaric on T2WI, and the boundary was clear. On MRI, T1WI showed low signal intensity on T _ 2WI and obvious non-uniform enhancement after contrast enhancement. The lesions were often accompanied with cysts, necrosis and bleeding components. Compared with HGG, there were statistically significant differences in multiple lesions, enhancement mode and involvement midline between primary brain lymphoma and HGG. T1WI enhanced images in brain lymphoma group and HGG group were analyzed by texture analysis. The entropy value and heterogeneity parameter of brain lymphoma group were lower than that of HGG group, and there was significant difference between them (P 0.05). At the same time, the heterogeneity parameters of texture analysis were obviously superior to entropy value, and when the heterogeneity parameter Cut-off was 0.175, the sensitivity, specificity and accuracy of differential diagnosis of brain lymphoma and HGG were 86.7% and 90.9%, respectively. Conclusion the entropy and heterogeneity parameters of texture analysis combined with conventional MRI plain scan and enhancement are valuable in differentiating primary brain lymphoma from HGG.
【作者单位】：徐州医科大学附属医院影像科;
【分类号】：R445.2;R739.41

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