DWI和最小ADC值鉴别诊断儿童颅内间变性室管膜瘤与室管膜瘤

DWI and minimum ADC value in differential diagnosis of intracranial anaplastic ependymomas from ependymomas in children

目的探讨DWI和最小ADC值鉴别诊断儿童颅内间变性室管膜瘤与室管膜瘤的价值。方法回顾性分析22例经手术及病理证实的儿童颅内间变性室管膜瘤及室管膜瘤的MRI资料,其中室管膜瘤8例、间变性室管膜瘤14例,所有患儿术前均接受MR平扫、增强和DWI检查。测量肿瘤实质部分的最小ADC值,比较两者之间的差异,并以ROC曲线分析其诊断效能。结果间变性室管膜瘤最小ADC值为(0.579±0.245)×10^(-3) mm^2/s,室管膜瘤最小ADC值为(0.943±0.128)×10^(-3) mm^2/s,差异有统计学意义(t=3.881,P=0.001)。ROC曲线结果显示,AUC为0.884(P=0.003),以最小ADC值=0.695×10^(-3) mm^2/s为临界值,鉴别诊断2种肿瘤的敏感度为100%,特异度为71.4%。结论最小ADC值在儿童颅内间变性室管膜瘤与室管膜瘤的鉴别诊断中具有较高临床应用价值,可作为常规MR检查的有效补充。

Objective To investigate the value of DWI and minimum ADC value differential diagnosis of intracranial anaplastic ependymomas from ependymomas in children.Methods MRI data of 22 children with ependymoma(n=8)or anaplastic ependymoma(n=14)confirmed by operation and pathology were retrospectively analyzed.All patients underwent plain and enhanced MR scanning and DWI before operation.The minimum ADC value of parenchymal part of the tumors were measured and compared between children with ependymoma and anaplastic ependymoma.Then ROC curve was used to identify the diagnostic efficacy of minimum ADC value.Results The minimum ADC value of anaplastic ependymoma was(0.579±0.245)×10^-3 mm^2/s,while of ependymoma was(0.943±0.128)×10^-3 mm^2/s.The difference was statistically significant(t=3.881,P=0.001).The AUC of ROC curve was of 0.884(P=0.003).Taken minimum ADC value=0.695×10^-3 mm^2/s as the threshold,the sensitivity was 100%,and the specificity was 71.4%.Conclusion The minimum ADC value has high clinical value in differential diagnosis of intracranial ependymoma and anaplastic ependymoma in children,which can be used as an effective supplement for routine MRI.