脑低级别胶质瘤与病毒性脑炎的诊断及鉴别诊断

Diagnosis and Differential Diagnosis of Low-Grade Glioma and Viral Encephalitis

目的:探究脑低级别胶质瘤与病毒性脑炎的诊断与鉴别诊断方法。方法:回顾性分析2017年4月-2019年4月期间经术后病理检查、生化检查以及治疗随访证实的病毒性脑炎患者18例与脑低级别胶质瘤患者12例的临床资料、影像学检查方法与结果。结果:(1)所有患者均接受扩散加权成像(DWI)与磁共振波谱(H-MRS)检查;(2)MIR显示两种疾病病变的T1W1、T2WI以及T2FLAIR的结果均较为相似,病灶周围均存在水肿;(3)H-MRS检查显示病毒性脑炎患者的平均ADC值[(1.472±0.033)×10^-3mm^2/s]较低级别胶质瘤的平均ADC值[(1.074±0.203)×10^-3mm^2/s]更高,P<0.05;前者的NAA/Cr、Cho/NAA以及Cho/Cr均较后者更低,P均<0.05。结论:H-MRS与DIW用于鉴别诊断脑低级别胶质瘤与病毒性脑炎的临床价值重大,能作为对常规MR检查的重要补充方法。

Objective:To investigate the diagnosis and differential diagnosis of low-grade glioma and viral encephalitis.Methods:Retrospective analysis of clinical data and images of 18 patients with viral encephalitis and 12 patients with low-grade glioma confirmed by postoperative pathological examination, biochemical examination and follow-up period from April 2017 to April 2019. Study methods and results.Results:(1) All patients underwent diffusion-weighted imaging(DWI) and magnetic resonance spectroscopy(H-MRS);(2) MIR showed similar results for T1 W1, T2 WI, and T2 FLAIR in both disease lesions. There is edema;(3) H-MRS examination showed that the average ADC value of patients with viral encephalitis [(1.472±0.033)×10^-3mm^2/s] average ADC value of lower grade glioma [(1.074±0.203)×10^-3mm^2/s] was higher, P<0.05;the former NAA/Cr, Cho/NAA and Cho/Cr were lower than the latter, P<0.05.Conclusion:The clinical value of H-MRS and DIW for differential diagnosis of brain low-grade glioma and viral encephalitis is important as an important supplement for routine MR examination.