ADC值在小脑半球原发性中枢神经系统淋巴瘤与单发转移瘤鉴别诊断中的价值

发布时间：2018-04-07 16:47

本文选题：表观扩散系数　切入点：磁共振成像　出处：《放射学实践》2017年04期

【摘要】：目的:探讨表观扩散系数(ADC)及rADC值对小脑半球原发性中枢神经系统淋巴瘤(PCNSL)和单发转移瘤的鉴别诊断价值。方法:回顾性分析经手术病理证实的位于小脑半球的12例PCNSLs和15例实性单发转移瘤患者的病例资料,所有患者均行常规MRI平扫、增强扫描及DWI检查。测量肿瘤实质区及对侧对称区域的平均ADC值,计算两者的比值(rADC),并采用两独立样本t检验比较2组患者间的差异。采用受试者工作特征曲线(ROC)分析rADC值的诊断效能。结果:PCNSLs在DWI上呈高信号11例、等信号1例,ADC均值为(0.62±0.11)×10~(-3)mm~2/s,rADC为0.93±0.15。单发转移瘤在DWI上表现为高信号11例、等或低信号4例,ADC均值为(0.76±0.18)×10~(-3)mm~2/s,rADC为1.13±0.26。两组间肿瘤的平均ADC及rADC值的差异有统计学意义(t=-2.12,P0.05;t=-2.50,P0.05)。以rADC值1.17为阈值时,鉴别PCNSL和单发转移瘤的敏感度为46.7%,特异度为100%,符合率为70.4%。结论:ADC及rADC值在小脑半球原发性中枢神经系统淋巴瘤与单发转移瘤的鉴别诊断中具有重要参考价值,可提高诊断准确性。
[Abstract]:Objective: to evaluate the value of apparent diffusion coefficient (ADCC) and rADC in differential diagnosis of primary central nervous system lymphoma (PCNS) and single metastases in the cerebellar hemisphere.Methods: the data of 12 cases of PCNSLs and 15 cases of solid single metastatic tumor confirmed by operation and pathology in cerebellar hemisphere were analyzed retrospectively. All patients underwent routine MRI plain scan, enhanced scan and DWI examination.The mean ADC values of tumor parenchyma and contralateral symmetric region were measured, and the ratio of the two were calculated. The difference between the two groups was compared by two independent samples t test.The diagnostic efficacy of rADC value was analyzed by using the operating characteristic curve of subjects.Results the mean value of DWI was 0.62 卤0.11 in 1 case and 0.93 卤0.15 in 1 case.On DWI, 11 cases of single metastatic tumor showed hyperintense signal, and the mean value of iso-or hypointense 4 cases was 0.76 卤0.18) 脳 10 ~ (-1) ~ (-3) mm ~ (-3) / s ~ (-1) / s ~ (r) ADC = 1.13 卤0.26.The difference of average ADC and rADC between the two groups was statistically significant.When the threshold value of rADC was 1.17, the sensitivity of differentiating PCNSL from single metastatic tumor was 46.7, the specificity was 100, and the coincidence rate was 70.4.Conclusion the ratio of rADC and the ratio of rADC are valuable in the differential diagnosis of primary central nervous system lymphoma and single metastases in the cerebellar hemisphere and can improve the diagnostic accuracy.
【作者单位】：郑州大学第一附属医院磁共振科;
【分类号】：R445.2;R739.4

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