MR-ADC值对脑脓肿和多形胶质母细胞瘤鉴别诊断的价值

MR-ADC values of brain abscess and glioblastoma multiforme differential diagnosis

目的:探讨磁共振扩散加权成像(DWI)表观扩散系数值(ADC)在鉴别脑脓肿与多形胶质母细胞瘤的价值。方法:回顾分析经手术病理或临床随访确诊的23例脑脓肿与8例多形胶质母细胞瘤病例,在手术切除或临床治疗前接受常规MR加增强及DWI序列检查,并测算肿瘤实质中央、壁及周围水肿带和对侧镜面正常区的ADC值,将分析指标的测量和(或)计算值,进行统计学处理。结果:23例脑脓肿与8例多形胶质母细胞瘤平扫及增强MR显示信号基本相似。22例脑脓肿在DWI上呈明显的高信号(壁除外),1例高且混杂信号;8例多形胶质母细胞瘤在DWI呈明显的低信号。脑脓肿中心坏死区及壁和周围水肿的平均ADC值分别是(0.33±0.15)×10-3、(1.14±0.06)×10-3和(1.74±0.21)×10-3mm2/s。胶质母细胞瘤中心坏死区及壁和周围水肿的平均ADC值为(2.07±0.031)×10-3、(1.64±0.254)×10-3和(1.39±0.164)10-3mm2/s。多形胶质母细胞瘤中心ADC值明显大于脑脓肿坏死区,壁及周边水肿;两者ADC值有差异。结论:MR-ADC值测量对脑脓肿和多形胶质母细胞瘤鉴别诊断具有重要价值。

OBJECTIVE：To investigate the values of diffusion-weighted imaging（DWI） and apparent diffusion coefficient（ADC） in differentiating brain abscess and glioblastoma multiforme.METHODS：Retrospectively analyzed 23 cases of brain abscess and 8 cases of glioblastoma multi-form cases confirmed by pathology or clinical follow-up,the parents received to examine plain and enhanced MR and DWI sequences before the clinical treatment or surgery.Measured in real terms in the central tumor,the wall and the surrounding edema and normal contralateral region ADC values of indicators,and calculated statistically the values.RESULTS：Totally 23 cases of brain abscess and 8 cases of glioblastoma multiforme plain and enhanced MR showed similar signal.And 22 cases of brain abscess were evident on the DWI high signal（wall excluded）,one case of high and mixed signals;8 cases of glioblastoma multiforme was significantly lower in the DWI signal.The average ADC values of central necrosis and brain abscess wall and surrounding edema were（0.33±0.15）×10-3,（1.14±0.06）×10-3 and（1.74±0.21）×10-3 mm2/s.The average ADC values of Glioblastoma central necrosis and surrounding edema wall and surrounding edema were（2.07±0.031）×10-3,（1.64±0.254）×10-3and（1.39±0.164）×10-3 mm2/s.The average ADC values of Glioblastoma multiforme was significantly greater than the average ADC values of central necrosis and brain abscess wall and surrounding edema.And both of the average ADC values were different.CONCLUSION：MR-ADC values measured on the brain abscess and glioblastoma multiformeis of great value in differential diagnosis.