ADC值在髓母细胞瘤瘤周浸润及复发评估中的价值

The values of ADC in evaluation of medulloblastoma peritumoral infiltration and recurrence

目的:探讨ADC值在髓母细胞瘤(MB)瘤周浸润及复发评估中的价值。方法:将具有手术病理证实、术前常规MRI平扫、增强和DWI检查,且术后至少2次MRI随访的29例MB患者,根据术后随访结果分为复发组与未复发组,将两组患者的肿瘤实质区、瘤周区最小ADC值,瘤周相对ADC值(瘤周区与对侧正常脑组织区最小ADC值的比值,即rADC)进行统计学分析,同时绘制ROC曲线,评估ADC值预测肿瘤浸润及复发的诊断效能。结果:29例MB患者中,复发组15例,未复发组14例。复发组的瘤周区最小ADC值[(0.558±0.053)×10^(-3) mm^2/s]小于未复发组[(0.637±0.043)×10^(-3) mm^2/s],两者差异具有统计学意义(Z=3.295,P<0.05);复发组的rADC值(0.853±0.065)小于未复发组(0.933±0.073),两者差异具有统计学意义(Z=2.581,P<0.05);瘤周区最小ADC值取0.606×10^(-3) mm^2/s时,预测MB瘤周细胞浸润的诊断敏感度为78.6%,特异性为73.3%。结论:ADC值对预测MB瘤周浸润及复发有辅助诊断价值。

Objective：To explore the values of ADC in evaluation of medulloblastoma （MB） peritumoral infiltration and recurrence. Methods： 29 MB patients confirmed by pathology underwent con- ventional MRI, contrast-enhanced MRI and DWI of the brain preoperatively, and MRI examination was performed at least twice after surgery in our hospital. According to postoperative follow-up MRI,they were divided into recurrent and non-recurrent group. The minimum ADC value of the tumor solid area and peritumoral area,the relative ADC value （the ratio of minimum ADC value between peritumoral area and the contralateral normal area, rADC） of peritumoral area between two groups were statistical- ly compared. Receiver operating characteristic （ROC） analyses were performed to determine the opti- mal thresholds for predicting the diagnostic efficacy of tumor invasion and recurrence. Results： 15 of 29 patients were in the recurrent group and 14 of 29 patients were in the non-recurrent group. The mini- mum ADC was 0. 558×10^-3 mm^2/s in recurrent group, and 0. 637×10^-3 mm^2/s in non recurrent group,with significantly statistical difference （Z=3.295,P〈0.05）. The rADC value of recurrent and non recurrent group was 0.853×10 3mm^2/s and 0. 933×10^-3mm^2/s respectively,and the difference was statistically significant （Z=2. 581 ,P〈0.05）. The minimum ADC value of peritumoral area had 78.6 % sensitivity and 73.3% specificity for predicting the peritumoral infiltration of MB at the cutoff value of 0. 606 × 10^-3mm^2/s. Conclusion： The ADC value is helpful in predicting the peritumoral infiltration and recurrence of MB.