弥散峰度成像对高级别脑胶质瘤和单发脑转移瘤的鉴别价值研究

The Value of DKI in the Differentiation of High Grade Brain Gliomas and Solitary Brain Metastasis

目的探讨弥散峰度成像(DKI)对鉴别高级别脑胶质瘤和单发脑转移瘤的临床应用价值。方法搜集经病理或临床证实的33例脑肿瘤患者纳入研究,其中高级别胶质瘤18例,单发脑转移瘤15例,分别行常规磁共振平扫、DKI及常规增强扫描。经后处理分别得到DKI相关参量图,分别测量在肿瘤实性部分、瘤周水肿区域的各参数值。采用两样本t检验,分析高级别脑胶质瘤与单发脑转移瘤实质部分和瘤周水肿区域的各相对参数值平均弥散峰度(MK)、部分各向异性(FA)、平均扩散系数(MD),分析差异有无统计学意义。结果在肿瘤实质部分,高级别脑胶质瘤和单发脑转移瘤MK、FA、MD各相对参数值比较,差异均无统计学意义(P值分别为0.529、0.645、0.84)。在瘤周水肿区域,高级别胶质瘤和单发脑转移瘤MK、FA、MD各相对参数值比较,差异均有统计学意义(P值分别为0.002、0.003、0.04)。结论 (1)DKI各相对参数MK、FA、MD在肿瘤实质部分对鉴别高级别脑胶质瘤和单发脑转移瘤没有明显价值。(2)DKI各相对参数MK、FA、MD在瘤周水肿区域对高级别脑胶质瘤和单发脑转移瘤有鉴别诊断价值。

Objective To investigate the clinical value of DKI in the differential diagnosis of highgrade brain gliomas and solitary brain metastasis.Methods From October 2013 to March 2014,thirty-three patients with pathologically or clinically confirmed brain tumors were included in the study,routine MR scans,DKI and conventional contrastenhanced sequence were performed.Of the 33 patients,18 were high grade brain gliomas,and 15 had solitary brain metastasis.The raw data of DKI were post processed.The MK、FA、MD values were measured in the region of solid part of the tumor.The DKI parameters in the region of solid part of the tumor,the peritumoral edema region were compared between highgrade brain gliomas and solitary brain metastasis using two sample t-test t-test.Results In the solid part of the tumors,relative MK,FA,MD values between highgrade brain gliomas and solitary brain metastasis did not show significant differences（P were 0.529,0.645,0.84,respectively）,while in the peritumoral edema region,relative MK,FA,MD values between highgrade brain gliomas and solitary brain metastasis showed significant differences（P were 0.002,0.003,0.04,respectively）.Conclusion（1） There was no value for relative MK,FA,MD values in the solid part to distinguish high grade brain gliomas and solitary brain metastasis.（2） There was significant value for relative MK、FA、MD values in the peritumoral edema region to distinguish highgrade brain gliomas and solitary brain metastasis.