表观扩散系数在中脑脚间区扩散高信号与急性脑梗死中的鉴别诊断价值

发布时间：2018-02-05 04:03

本文关键词： 中脑脑梗死表观扩散系数磁共振成像扩散　出处：《临床放射学杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨表观扩散系数(ADC)在中脑脚间区扩散高信号与急性脑梗死鉴别诊断中的价值。方法回顾性分析经临床证实的中脑脚间区急性脑梗死31例(病例组)、健康受检者31例(对照组,中脑脚间区在DWI上呈高信号)。均行常规MRI及DWI。由两名医师先采用双盲法独立对图像进行评估,并采用组内相关系数(ICC)值分析两名医师测量ADC值的一致性。计算两名医师测量ADC值的平均值,并采用独立样本t检验比较病例组与对照组ADC值的差异。以临床结果为金标准绘制ADC值诊断中脑脚间区急性脑梗死的ROC曲线,判断最佳诊断界值点,计算ADC值诊断中脑脚间区急性脑梗死的敏感性、特异性和准确性。结果两名医师测量ADC值的一致性好(ICC=0.926,P0.001)。对照组ADC值为(635.69±54.16)×10~(-6)mm~2/s(95%可信区间为615.83~655.56×10~(-6)mm~2/s),病例组ADC值为(472.08±87.65)×10~(-6)mm~2/s(95%可信区间为439.93~504.23×10~(-6)mm~2/s),差异有统计学意义(t=8.842,P=0.000)。ADC值诊断中脑脚间区急性脑梗死的ROC曲线下面积为0.935,最佳诊断界值为546×10~(-6)mm~2/s,诊断中脑脚间区急性脑梗死的敏感性为87.1%(27/31),特异性为93.5%(29/31)淮确性为90.3%(56/62)。结论 ADC值有助于中脑脚间区扩散高信号与急性脑梗死的鉴别。
[Abstract]:Objective to investigate the value of apparent diffusion coefficient (ADCC) in the differential diagnosis of acute cerebral infarction (ADCA) and high signal diffusion (ADCC) in the interpeduncular area of the mesencephalon (ADCA). Methods 31 cases of acute cerebral infarction in the interpeduncular area of the midbrain proved by clinical diagnosis were retrospectively analyzed. Case group). 31 healthy subjects (control group, interpeduncular area showed high signal intensity on DWI. Both routine MRI and DWI) were performed. The images were evaluated by double blind method. The correlation coefficient was used to analyze the consistency of ADC measured by two physicians, and the average value of ADC measured by two physicians was calculated. The difference of ADC value between the case group and the control group was compared with the independent sample t-test. The ROC curve of the diagnosis of acute cerebral infarction in the interpeduncular area of the midbrain was plotted according to the clinical results as the gold standard. The sensitivity, specificity and accuracy of the ADC value in the diagnosis of acute cerebral infarction in the interpeduncular area of the midbrain were calculated. Results the consistency between the two physicians in measuring the ADC value was good. The ADC value of the control group was 635.69 卤54.16) 脳 10 ~ (-1) ~ (-6) mm ~ (-1) / s (P _ (0.001)). The 95% confidence interval (CI) was 615.83 脳 105.56 脳 10 ~ (-6) mm ~ (-2 / s). The ADC value of the case group was 472.08 卤87.65) 脳 10 ~ (-1) ~ (-6) / s 95% confidence interval (CI) was 439.93 ~ 504.23 脳 10 ~ (-6)). 2 / 2 / s. The difference was statistically significant. The area under the ROC curve was 0.935 for the diagnosis of acute cerebral infarction in the interpeduncular area of the midbrain. The best diagnostic threshold was 546 脳 10 ~ (-6) mm ~ (-1) / s, and the sensitivity of diagnosing acute cerebral infarction in the interpeduncular area was 87.1 / 27 / 31). The specificity is 93.5 / 29 / 31) the accuracy is 90.33 / 62.Conclusion the ADC value is helpful for the differential diagnosis of acute cerebral infarction with diffusive hyperintensity in the interpeduncular area of the midbrain.
【作者单位】：山东省泰安市中心医院医学影像部;
【分类号】：R445.2;R743.3
【正文快照】： 健康人群中扣带回、岛叶以及中脑脚间区在扩散加权成像(diffusion-weighted imaging,DWI)中常表现为高信号[1,2],这些正常的扩散高信号区域在临床实践中经常可见,虽然它们并非真正的扩散受限,但是在临床工作中有时可误认为真正的扩散受限,尤其是中脑脚间区的扩散高信号可与脑

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