3.0T DWI对髓外硬膜下肿瘤鉴别诊断价值的初步研究

The Preliminary Study of DWI in Differential Diagnosis of Intradural Extramedullary Tumors on 3.0T MR

目的应用3.0 T超导型磁共振对髓外硬膜下肿瘤行扩散加权成像(DWI)检查,探讨DWI对髓外硬膜下肿瘤鉴别诊断的价值。方法 74例髓外硬膜下肿瘤患者行3.0 T DWI检查,采用单次激发自旋回波平面成像(SE-EPI)序列,扩散梯度因子b值为600 s/mm2,分析不同肿瘤DWI图像信号特点,比较不同肿瘤ADC值的差异。结果 74例患者均获得较满意的DWI和ADC图像。神经源性肿瘤中16例在DWI图上表现为不均匀稍低信号,10例在DWI图上表现为不均匀稍高信号;17例脊膜瘤表现为均匀或不均匀等或稍高信号;8例脂肪瘤完全为均匀低信号;14例表皮样囊肿为不均匀高信号。而9例畸胎瘤呈混杂信号。各肿瘤之间及与邻近脊髓间ADC值均具有明显统计学差异(P<0.05)。结论 DWI通过各肿瘤间DWI图像信号强度不同及定量测量ADC值,有助于对髓外硬膜下不同肿瘤鉴别诊断。

Objective To investigate the value of DWI in differential diagnosis of intradural extramedullary tumors.Methods 74 cases with intradural extramedullary tumor were examined with DWI on 3.0 T MRI.SE EPI sequence was used with b value of 600s/mm2.The signal charateristic of the DWI and ADC value of different tumors were compared.Results The image quality of DWI and ADC map were relatively satisfactory in the 74 patients.On DWI,16/26 cases with neurogenic tumor showed inhomogeneous slightly hypointensity,and other 10 cases showed inhomogeneous slightly hyperintensity.All 17 spinal meningiomas showed homogeneous or inhomogeneous isointensity or sightly hyperintensity.8 lipomas showed completely homogeneous hypointensity.14 epidermoid cysts showed inhomogeneous hyperintensity.However,9 teratomas showed mixed signal intensity.The ADC value between these tumors,even between tumors and adjacent spinal cord was obviously different（P0.05）.Conclusion The signal intensity and ADC value of DWI are helpful to differential diagnosis of various intradural extramedullary tumors.