酰胺质子转移加权成像在鉴别儿童颅内肿瘤性和感染性肿块病变中的应用

Application value of APTw imaging in differentiation of intracranial neoplastic and infective mass lesions in children

目的评价酰胺质子转移加权(APTw)成像技术在鉴别儿童颅内肿瘤和感染性肿块病变中的应用价值。方法选择2016-02至2019-08就诊于北京儿童医院的35例儿童颅内肿瘤患者以及12例颅内感染患者纳入本研究。均进行了APTw MRI成像和常规MR序列扫描,比较肿瘤性肿块和感染性肿块的APTw值,比较不同颅内肿块病变(ICMLs)(低级别颅内肿瘤、高级别颅内肿瘤和感染性肿块病变)的APTw值,评价APTw值在鉴别肿瘤性病变和感染性肿块病变,以及鉴别ICMLs中的应用价值。结果感染性肿块病变的APTw值要显著低于肿瘤性肿块病变的APTw值。APTw值鉴别肿瘤性和感染性肿块病变最佳临界值为2.30%,敏感性和特异性分别为88.6%和70.8%,曲线下面积为0.857。结论APTw MRI成像可以很好地区分儿童颅内肿瘤性病变和感染性肿块病变,以及不同类型的ICMLs。

Objective To evaluate the role of amide proton transfer-weighted(APTw)MRI in differentiating neoplastic and infective mass lesions in children.Methods Thirty-five children with intracranial tumor and 12 children with intracranial infection who were admitted into Beijing Children’s Hospital from February 2016 to August 2019 were included in this study.APTw imaging and conventional MR sequences were performed with a MRI scanner.The independent sample t test was used to compare the APTw values of neoplastic and infective mass lesions.One-way analysis of variance and Dunnett T3 post-hoc test was used to compare the APTw values of different intracranial mass lesions(ICMLs)(low-grade intracranial tumors,high-grade intracranial tumors and infective mass lesions).ROC curve analysis was used to evaluate the application value of APTw in the identification of neoplastic and infective mass lesions and the identification of ICMLs.Results The APTw value of infective mass lesions was significantly lower than that of neoplastic mass lesions.The best cut-off value of APTw for distinguishing neoplastic and infective mass lesions was 2.30%,the sensitivity and specificity were 88.6%and 70.8%respectively,and the area under the curve was 0.857.Conclusions APTw MRI imaging can distinguish neoplastic mass lesions from infective mass lesions and different types of ICMLs.