高场MRI多b值DWI在良恶性脑膜瘤诊断中的应用

Application of high-field MRI multi B value of diffusion weighted imaging in the diagnosis of benign and malignant meningiomas

目的 :通过测量不同病理类型脑膜瘤的双指数模型ADCstandard值、ADCfast值、ADCslow值、ADCfast成分所占比例(f值),评价双指数模型DWI在脑膜瘤良、恶性鉴别诊断中的应用价值,进而为临床提供更加详实可靠的测量数据和影像诊断。方法:测量脑膜瘤良、恶性瘤体及瘤体对侧镜像区正常脑白质的ADCstandard值、ADCfast值、ADCslow值、f值,并进行统计比较。结果:1良性脑膜瘤的b值-信号强度曲线斜率高于恶性脑膜瘤。2良性脑膜瘤瘤体区与瘤体对侧镜像区正常脑白质比较,ADCstandard值、ADCfast值、ADCslow值、f值均增加(均P<0.05)。3恶性脑膜瘤瘤体区与瘤体对侧镜像区正常脑白质及良性脑膜瘤瘤体区比较,ADCstandard值、ADCslow值均减少,ADCfast值、f值均增加(均P<0.05),且ADCslow值在良、恶性脑膜瘤组间差异有统计学意义。4鉴别诊断良、恶性脑膜瘤病变的ADCstandard值、ADCslow值、ADCfast值、f值最佳阈值分别为0.617×10-3mm2/s、0.503×10-3mm2/s、5.9×10-3mm2/s、39%。结论:多b值体素不相干运动成像(IVIM)双指数模型可为鉴别诊断良、恶性脑膜瘤病变提供重要依据,能够更准确地描述脑膜瘤病变的扩散信息,同时无创获得脑膜瘤灌注信息。

Objective：Applied multi b value of double exponential model DWI, measured different pathological types of meningioma tumors ADCstandarch, ADCfast ADCslow, ADCfast composition proportion （F value）,evaluated identification value of multi b value of double exponential model DWI in the diagnosis of benign and malignant meningiomas. Method： Measurement of benign and malignant meningioma tumors and tumors of the contralateral mirror area of normal cerebral white matter ADCstandarch, ADCfast ADCslow, ADCfast composition proportion （F value）,and a statistical comparison was carried out.The statistical analysis was based on the data from independent samples,and validated with t-test. Results：（1）The b value-slop of signal intensity curves of benign meningioma were higher than malignant meningioma. （1）Benign meningioma tumors and tumors on side mirror area normal brain white matter：ADCstandarch, ADCfast ADCslow, ADCfast composition proportion （F value） were higher than normal brain white matter,which was statistically different as p value was below 0.05. （3）Malignant meningioma tumors and tumors on side mirror area normal cerebral white matter and benign meningioma tumors area comparison：ADCstandarch, ADCfast values were reduced,ADCslow value, ADCfast composition proportion （F value） were increased,P values 〈0.05 difference was statistically significant. Benign and malignant meningioma and ADCslow value in the biggest difference between the groups. （4）The threshold to differentially diagnosis of benign/malignant meningioma of ADCstandarch, ADCfast ADCslow, ADCfast components were 0.617×10-3mm2/s、0.503×10-3mm2/s、5.9×10-3mm2/s,39% respectively. Conclusion：The multi b value IVIM dual exponential model provides an important basis for diagnosis of benign/malignant meningioma,and is able to track the spread of tutor more accurately. In addition,this approach enables us to obtain the perfusion information of meningioma in a non-invasive manner.