DWI联合ADC在脑肿瘤鉴别诊断中的价值

Significance of DWI combined with ADC in differential diagnosis of brain tumors

目的探讨磁共振扩散成像(DWI)联合表观弥散系数(ADC)对脑肿瘤鉴别诊断的价值。方法选取2012年5月至2018年2月间西安市第四医院收治的81例实施磁共振检查的脑部分肿瘤患者,均行头颅MRI常规平扫、常规增强扫描及DWI联合ADC检查。比较良恶性脑肿瘤间、肿瘤侧与对照侧间及高低级别脑胶质瘤间的DWI信号强度和ADC值,比较DWI信号强度、ADC值及DWI联合ADC对恶性脑肿瘤的诊断灵敏度、特异度和准确度。结果当b=400s/mm^2、600s/mm^2和1 000s/mm^2时,恶性组患者DWI信号强度高于良性组,ADC值低于良性组,高级别组患者DWI信号强度高于低级别组,ADC值低于低级别组,差异均有统计学意义(均P <0. 05)。良性组和恶性组的DWI信号强度均高于对照组,ADC值均低于对照组,差异均有统计学意义(均P <0. 05)。DWI联合ADC的灵敏度、特异度和准确度均高于DWI信号强度和ADC值诊断(P <0. 05);DWI信号强度和ADC值诊断效能比较,差异无统计学意义(P> 0. 05)。结论 DWI信号强度和ADC值可用于鉴别脑肿瘤的良恶性及高、低级别胶质瘤,而取不同b值时得到不同的DWI信号强度和ADC值,且DWI联合ADC可明显提高DWI信号强度和ADC值对脑肿瘤的诊断效能。

Objective To investigate the value of diffusion weighted imaging( DWI) combined with apparent diffusion coefficient( ADC) in differential diagnosis of brain tumors. Methods A total of 81 patients with partial brain tumors were selected at Xi’an No. 4 Hospital from May 2012 to February 2018.Conventional magnetic resonance imaging( MRI),plain scan conventional enhanced scan and DWI combined with ADC examination were performed on all the patients. The DWI signal intensity and ADC values between benign and malignant brain tumors,between tumor side and control side,and between high and low grade gliomas were compared,and the diagnostic sensitivity,specificity and accuracy of DWI signal intensity,ADC value and DWI combined ADC for malignant brain tumors were compared. Results When b =400 s/mm^2,600 s/mm^2 and 1 000 s/mm^2,the intensity of DWI signal was higher in the malignant group than in the benign group and the ADC value was lower in the malignant group in the benign group( all P <0. 05). The DWI signal intensity was higher in the high-level group than in the low-grade group and the ADC value was lower in the high-level group than in the low-grade group( all P < 0. 05). The DWI signal intensity was higher in the benign group and the malignant group than in the control group and the ADC value was lower than in the benign group( all P < 0. 05). The sensitivity,specificity and accuracy of DWI combined ADC were higher than that of DWI signal strength and ADC value diagnosis( all P < 0. 05),and the difference between DWI signal strength and ADC value diagnosis was not statistically significant( P >0. 05). Conclusion DWI signal intensity and ADC value could be used to identify benign and malignant brain tumors and high and low grade gliomas,while different DWI signal intensity and ADC value is obtained when taking different b values,and DWI combined with ADC can significantly improve the diagnostic efficacy of DWI signal intensity and ADC value for brain tumors.