磁共振DWI和ADC值在包膜期脑脓肿与坏死囊变性脑肿瘤鉴别诊断中的应用

Use of MR DWI and ADC value in the differential diagnosis between integument-term brain abscesses and necrotic-cystic brain tumors

目的探讨磁共振扩散加权成像(DWI)及表观扩散系数(ADC)值在包膜期脑脓肿与坏死囊变脑肿瘤鉴别中的临床应用价值。方法经手术病理证实的包膜期脑脓肿15例和坏死囊变脑肿瘤20例患者均经常规MRI扫描和DWI扫描,对比分析包膜期脑脓肿及坏死囊变脑肿瘤的DWI和ADC图表现,并测量脑脓肿脓腔及脑肿瘤坏死囊变区内的平均ADC值,进行统计学分析。结果包膜期脑脓肿脓腔在DWI上表现为高信号,ADC图呈低信号;脑肿瘤坏死囊变区在DWI上表现为低信号,ADC图呈高信号。所有脑脓肿的平均ADC值为(0.69±0.18)×10-3mm2/s,坏死囊变脑肿瘤的平均ADC值为(2.43±0.16)×10-3mm2/s,两者比较有显著性差异(P<0.01)。结论 DWI与ADC值测量能准确反映包膜期脑脓肿与坏死囊变脑肿瘤的不同液态性质,对其鉴别诊断有重要价值。

Objective To study the clinical utility of magnetic resonance diffusion-weighted imaging（MR DWI） and apparent diffusion coefficient（ADC） value in the differential diagnosis between integument-term brain abscesses（ITBA） and necrotic-cystic brain tumors（NCBT）.Methods Thirty-five patients who comprised 15 ITBAs and 20 NCBTs confirmed by surgery and pathology underwent conventional MRI and DWI scans.DWI and ADC picture findings in both group patients ITBA and NCBT were comparatively analyzed.ADC values in the cavities of brain abscesses and the necrotic-cystic areas of brain tumors were measured and statistically analyzed.Results ITBA lesions appeared hyperintensity on DWIs and hypointensity on ADC pictures,while NCBT lesions appeared hypointensity on DWIs and hyperintensity on ADC pictures.The mean ADC value of all ITBA patients was（0.69±0.18） × 10-3 mm2/s,while that of all NCBT patients was（2.43±0.16） × 10-3 mm2/s,comparison between both groups was significant difference（P 0.01）.Conclusion DWI and ADC value measurements could accurately reflect the different liquid properties of ITBA and NCBT,which has important value to differentiate the former from the latter.