瘤周水肿区最小表观扩散系数值在原发中枢神经系统淋巴瘤与胶质母细胞瘤中的鉴别诊断价值

Value of Minimum Apparent Diffusion Coefficient in Peritumoral Edema in the Differential Diagnosis between Primary Central Nervous System Lymphoma and Glioblastoma

目的探讨磁共振扩散加权成像瘤周水肿区最小表观扩散系数(MinADC)值对原发中枢神经系统淋巴瘤与胶质母细胞瘤的鉴别诊断价值。方法分析经病理证实的16例原发中枢神经系统淋巴瘤(弥漫大B细胞淋巴瘤)和31例胶质母细胞瘤(WHOⅣ级)的瘤周水肿区MinADC值。在表观扩散系数图上采用感兴趣区法测量瘤周水肿区表观扩散系数值,并获得MinADC值。采用独立样本t检验及受试者操作特征曲线分析。结果原发中枢神经系统淋巴瘤MinADC值[(1.20~1.45)×10^(-3)mm^2/s,平均(1.35±0.68)×10^(-3)mm^2/s]明显高于胶质母细胞瘤[(0.95~1.31)×10^(-3)mm^2/s,平均(1.12±0.09)×10^(-3)mm^2/s](t=9.977,P=0.000)。受试者操作特征曲线下面积为0.986,鉴别原发中枢神经系统淋巴瘤和胶质母细胞瘤的MinADC值最佳截断点为1.245×10^(-3)mm^2/s,其灵敏度和特异度分别为94.1%和94.1%。结论 MinADC值可以作为鉴别原发中枢神经系统淋巴瘤与胶质母细胞瘤的简单有效的方法。

Objective To evaluate the role of minimum apparent diffusion coefficient(MinADC)values in peritumoral edema based on magnetic resonance diffusion weighted imaging in the differential diagnosis between primary central nervous system lymphoma(PCNSL)and glioblastoma(GBM).Methods ADC values in peritumoral edema were measured in 16 patients with PCNSL(diffuse large B cell lymphoma)and 31 patients with GBM(WHO gradeⅣ)confirmed by pathology.Regions of interests were manually drawn on ADC maps on peritumoral edema regions to obtain the MinADC value.Independent samples t-test and receiver operating characteristic analysis were performed for statistical analysis.Results The MinADC value[(1.20-1.45)×10-3 mm 2/s,mean(1.35±0.68)×10-3 mm 2/s]in PCNSL was significantly higher than that in GBM[(0.95-1.31)×10-3 mm 2/s,mean(1.12±0.09)×10-3 mm 2/s](t=9.977,P=0.000).The area under the receiver operating characteristic curve was 0.986,and the cutoff value of MinADC was 1.245×10-3 mm 2/s for the differentiation between PCNSL and GBM,with the best combination of sensitivity(94.1%)and specificity(94.1%).Conclusion MinADC value can be a simple and effective measure for the differential diagnosis between PCNSL and GBM.