磁共振弥散加权成像鉴别诊断脑脓肿与脑肿瘤坏死的临床研究

Clinical value of diffusion-Weighted imaging in the differential diagnosis of brain abscess and necrotic brain tumor

目的探讨磁共振弥散加权像(DWI)及表观弥散系数值(ADC)对脑脓肿与坏死囊变脑转移瘤诊断和鉴别的意义。方法选取2011-01—2015-01于我院进行脑脓肿、脑肿瘤坏死治疗的患者为研究对象,其中脑脓肿10例,脑肿瘤坏死12例,均进行常规磁共振检查及弥散加权检查。应用1.5T磁共振机SE-EPI序列,取b=1 000s/mm2,b=0s/mm2在脑脓肿脑炎期、包膜期及吸收期进行弥散信号测量,获得DWI图像,同时测量表观弥散系数值,并与坏死囊变脑转移瘤比较。结果常规MRI诊断敏感性、特异性分别为75%、70%,DWI诊断敏感性、特异性则分别为92%、90%;10例脑脓肿9例磁共振弥散加权图像表现为高信号,表观弥散系数值为0.335±0.098,12例脑肿瘤中11例坏死囊变部分磁共振弥散加权图像表现为低信号,表观弥散系数值2.481±0.391。结论在鉴别脑脓肿和坏死、囊变脑肿瘤方面磁共振弥散加权成像诊断的敏感性和特异性均明显高于常规MR诊断,帮助提高诊断的正确性。

Objective To investigate the clinical value of diffusion-Weighted imaging（DWI）and apparent diffusion coefficient（ADC）in the differential diagnosis of brain abscess and necrotic brain tumor.Methods In our study,we selected 10 cases with brain abscess and 12 cases with necrotic brain tumor treated in our hospital from January 2011 to January 2015 as objects.All cases received DWI and ADC examinations,then the related parameters of two groups were compared.Results Diagnostic sensitivity and specificity by using general MRI were 75% and 70%,which were 92% and 90% by using DWI.Of the 10 selected cases with brain abscess,9cases presented high signal in diffusion-Weighted images with ADC value of 0.335±0.098;Similarly,of 12 cases with brain tumors,11 cases with cystic necrosis showed low signal in diffusion-Weighted images with ADC value of 2.481±0.391.Conclusion DWI has higher sensitivity and specificity in the differential diagnosis of brain abscess and necrotic brain tumor,which can help to improve diagnostic accuracy.