ADC及DCE-MRI对鉴别诊断血管瘤型脑膜瘤与血管周细胞瘤的价值

Value of ADC and DCE-MRI in Differential Diagnosis of Angiomatous Meningioma and Solitary Fibrous Tumors/Hemangiopericytoma

目的探究表观扩散系数（ADC）及动态增强（DCE）MRI对鉴别诊断血管瘤型脑膜瘤（AM）与血管周细胞瘤（SFT/HPC）的价值。方法回顾性分析经病理证实的17例AM及18例SFT/HPC患者的MRI资料,通过分析其年龄、性别、ADC、时间-信号强度曲线（TIC）类型、峰值（SImax）、达峰时间（Tmax）、最大对比增强率（MCER）和早期强化率（EER）,比较两种肿瘤的差异。评价ADC及DCE-MRI鉴别诊断AM与SFT/HPC的效能、ADC值和DCE-MRI与年龄的相关关系。采用两独立样本t检验,校正t检验、卡方检验及秩和的统计学方法和Pearson相关。结果AM与SFT/HPC的ADC、MCER[（0.91±0.03）×10^（-3）mm^2/s vs（1.20±0.05）×10^（-3）mm^2/s,（304.59±34.43）%vs（179.88±27.54）%]及性别差异有统计学意义（P〈0.05）。绘制ROC曲线后,鉴别AM与SFT/HPC的ADC、MCER阈值分别为1.03×10^（-3）mm^2/s、226.7%。AM 6例Ⅰ型,10例Ⅱ型,1例Ⅲ型;SFT/HPC 5例Ⅰ型,9例Ⅱ型,4例Ⅲ型。而两种肿瘤的年龄、SImax、Tmax、EER差异无统计学意义（P〉0.05）。AM年龄与ADC值、SFT/HPC年龄与ADC值均有呈线性相关。结论AM ADC值小于SFT/HPC,AM MCER值大于SFT/HPC,ADC较MC-ER更具价值,这些参数有助于鉴别诊断。

Objective This study aimed to assess the value of ADC and DCE-MRI in the differential diagnosis of angiomatous meningioma and solitary fibrous tumors/hemangiopericytoma.Methods A total of 17 cases of AM and 18 cases of the SFT/HPC confirmed by pathology were analyzed retrospectively.All of patients underwent ADC and DCE-MRI.Age,gender,ADC,TIC,SImax,Tmax,MCER and EER were measured and compared AM between SFT/HPC.The diagnostic efficacy of ADC and DCE-MRI in distinguishing AM and SFT/HPC were calculated and correlation of ADC and DCE-MRI with age was determined.Two independent samples t tests、t＇test,chi-square test and Wilcoxon rank sum test and Pearson correlation were used.Results The ADC value[（0.91±0.03）×10^（-3）mm^2/s]、MCER[（304.59±34.43）%]of 17cases of AM were statistically different from 18 cases of SFT/HPC[（1.20±0.05）×10^（-3）mm^2/s,（179.88±27.54）%]and gender,too（P〈0.05）.The cut-off value of ADC and MCER were respectively 1.03×10^（-3）mm^2/s and 226.7%in differential diagnosis of AM and SFT/HPC.There were 6 typeⅠTICs,10 typeⅡTICs,1 typeⅢTICs in 17 cases of AM.There were 5 typeⅠTICs,9 typeⅡTICs,4 typeⅢTICs in 18 cases of SFT/HPC.The age,SImax,Tmax and EER were not statistically different between the two tumors（P〉0.05）.The age of AM and ADC value,age of SFT/HPC and ADC value were all linearly dependent.Conclusion ADC value of AM is less than SFT/HPC＇s;MCER of AM is greater than SFT/HPC＇s,and ADC is more valuable than MCER,and these parameters can help in the diagnosis of AM.