MR弥散张量成像在颅内肿瘤的应用

Applicable study of DTI in brain neoplasms

目的:研究DTI在不同颅内肿瘤中的应用,探讨ADC及FA在诊断和鉴别诊断中的价值。方法:本研究共39例颅内肿瘤,胶质瘤12例、脑膜瘤10例、淋巴瘤8例、神经鞘瘤9例,病例除1例淋巴瘤经放疗后病变明显好转证实外,其余均经手术病理证实。建立彩色弥散张量图,在肿瘤的实质区选择感兴趣区,测量得ADC值和FA值,分析二者在不同肿瘤之间的差异。结果:神经鞘瘤ADC值最高,脑膜瘤FA值最高。神经鞘瘤的ADC值和FA值与脑膜瘤均具有显著性差异(P<0.05)。淋巴瘤ADC值最低,与胶质瘤有显著性差异(P<0.05),两者FA值无显著性差异(P>0.05)。肿瘤周围白质纤维束可见受压移位、浸润及破坏三种改变。结论:不同颅内肿瘤的ADC和FA存在明显差异,DTI可显示颅内肿瘤与白质结构的位置关系及术前术后白质纤维束形态改变。

Objective：Our aim was to evaluate the role of diffusion tensor imaging（DTI） in the differentiation of these cerebral tumors and to investigate the value of diagnosis with regard to apparent diffusion coefficient （ADC） and fractional anisotropy（FA）.Methods：This study have 39 case of brain neoplasms,including 12 case of glioma,10 case of meningioma,8 case of lymphoma,9 case of neurinoma.All case were confirmed by pathology after surgery,except 1 of lymphoma confirmed by radiotherapeutics.By reconstrusting color -tentor, we choose the solid area of tumors as region of interest（ROI） and measure ADC and FA of ROI.The differentiation of ADC and FA among the four types of tumors were analyzed,also.Results：ADC of neurinoma is the highest,and FA of meningoma is the highest.ADC and FA between neurinoma and Meningoma has significant difference（P0.05）.ADC of lymphoma is the lowest,and has significant difference with glioma（P0.05）,but FA has not significant difference（P0.05）.White matter fiber of surrounding tumors have three shapes,including compression with shifting,inflitration and destruction before surgery.Conclusion： Characteristics of ADC and FA with brain tumors have significant difference.It could be described precisely relationship between tumors and white matters and the shape of fiber including preoperative and after operation by using DTT.