MRI弥散加权成像对胶质瘤分级的临床价值

Clinical application of MR diffusion weighted imaging in classification of glioma

目的探讨MRI弥散加权成像对胶质瘤病理分级的诊断价值。方法对经手术病理证实的27例胶质瘤患者进行常规MRI序列扫描和DWI检查，对照分析病变的实质部分、周围水肿区以及正常脑组织的ADC值、eADC值。结果12例Ⅲ、Ⅳ级胶质瘤中，6例肿瘤实质部分于DWI表现为高信号，4例为等信号，2例为低或稍低信号。15例Ⅰ、Ⅱ级胶质瘤中，3例肿瘤实质部分于DWI表现为高信号，5例为等信号，7例为低或稍低信号。胶质瘤的ADC值和eADC值均与正常的脑组织差异有统计学意义（P〈0．05）；Ⅲ、Ⅳ级胶质瘤实质部分的ADC值和eADC值分别较Ⅰ～Ⅱ级胶质瘤瘤体低和高（P〈0．05）；其瘤周水肿区的ADc值（eADC值）明显低于（高于）Ⅰ～Ⅱ级胶质瘤（P〈0．05）。结论ADC值（eADC值）结合常规MRI序列的特征，对于胶质瘤的分级诊断具有临床应用价值。

Objective To explore the clinical value of diffusion weighted imaging（DWI） in the classification of glioma. Methods Twenty-seven patients with histologically proved gliomas underwent routine and diffusion weighted imaging. Comparisons of ap- parent diffusion coefficients（ ADC） and exponential diffusion coefficients（eADC） were done among tumor parenchymas, peripheral edema regions and normal tissues. Results Of 12 cases of grade Ⅲ,Ⅳ gliomas,tumor parenchymas of 6,4,2 glioma exhibited hyper, iso, hypo-intensity on DWI respectively, while of 15 cases of grade Ⅰ ,Ⅱ , tumor parenchymas of 3,5,7 glioma exhibited hyper, iso,hypo-intensity on DWI respectively. The ADC or eADC had significantly statistical difference between glioma and normal brain tissue（P〈0.05）. The ADC or eADC of grade Ⅲ,Ⅳ gliomas were respectively lower or higher than those of gradeⅠ ,Ⅱ ones（P〈 0.05）. The ADC（eADC） in peripheral edema regions of grade Ⅲ , Ⅳ gliomas were significantly lower（higher） than those of grade Ⅰ ,Ⅱ ones（P〈0.05）. Conclusion The ADC（eADC） combined with routine MRI findings is of clinical application value in the classification of gliomas.