定量T1值和ADC值在区分脑肿瘤瘤周水肿性质中的价值

Quantitative T1 and ADC value in identifying the nature of peritumoral edema of cerebral tumors

目的脑肿瘤瘤周水肿区的性质是影响患者预后的重要因素之一,其性质在很大程度上取决于脑肿瘤组织的病理学亚型。本文旨在探究定量ADC值和T1值在区分血管性水肿和浸润性水肿中的价值。方法26例脑肿瘤占位的患者在手术前接受了MR检查。按照病理结果分为两组,其中11例归为血管源性水肿组,15例归为浸润性水肿组。分别记录肿瘤强化区域和瘤周水肿区的平均ADC值和T 1值(分别记作ADC强化、T1强化、ADC瘤周和T1瘤周)。Mann-Whitney U检验验证两组间的统计学差异。受试者操作曲线评估参数的鉴别诊断效能。结果ADC瘤周和T1瘤周在两组间有明显统计学差异(P<0.001)。ADC瘤周的ROC下面积为0.92,敏感性为82.6%,特异性为93.4%。T1瘤周的ROC下面积为0.93,敏感性为85.1%,特异性为95.3%。二者曲线下面积无统计学差异(P=0.476)。联合ADC瘤周和T1瘤周的混合模型与单一指标在ROC下面积无统计学差异(P=0.538)结论瘤周水肿区的ADC值和T1值能有效鉴别浸润性水肿和血管源性水肿,但是二者的鉴别效能没有统计学差异,两种指标联用时的鉴别效能较单一指标亦没有统计学差异。

Objective The nature of peritumoral edema area of brain tumors is one of the important factors affecting the prognosis of patients.The purpose of this study was to explore the value of quantitative ADC value and T1 value in differentiating vasogenic edema from infiltrative edema.Methods 26 patients with brain tumors were examined by MR before operation.According to the pathological results,11 patients were classified as vasogenic edema group and 15 patients as infiltrative edema group.Average ADC values and T1 values in tumor enhancement area and peritumoral edema area were recorded respectively(classified as ADCenhancement,T1 enhancement,ADCperitumor and T1 peritumor).The Mann-Whitney U test confirmed the statistical difference between the two groups.Receiving operating curve was used to validate the distinguishing performance of each parameter.Results There were statistically significant differences between ADCperitumor and T1 peritumor(P<0.001).The area under ROC of ADCperitumor was 0.92,the sensitivity was 82.6%,and the specificity was 93.4%.The area under ROC of T1 peritumor was 0.93,the sensitivity was 85.1%,and the specificity was 95.3%.There was no statistical difference in the area under the curves between the two parameters(P=0.476),as well as the area under ROC of combined parameters(P=0.538).Conclusion ADC value and T1 value in peritumoral edema area can effectively distinguish infiltrative edema from vasogenic edema,but there is no statistical difference between the two parameters,and the combination of the two parameters cannot effectively improve the diagnostic efficacy.