以增强T2-FLAIR为参照测量近瘤周区ADC值在脑转移瘤与高级别胶质瘤鉴别诊断中的价值

The Value of Measuring ADC Values in the Peritumoral Area Using Enhanced T2 FLAIR as A Reference in the Differential Diagnosis of Brain Metastases and High-grade Hliomas

目的探讨以增强T2-FLAIR序列为参照测量近瘤周水肿区的ADC值及rADC值鉴别脑内转移瘤及高级别胶质瘤的价值;方法收集行常规T1增强及T2-FLAIR增强和DWI检查的高级别胶质瘤34例与30例脑转移瘤,将瘤周10mm范围内作为感兴趣区(regions of interest,ROI)测量ADC值,并计算相应的rADC值。结果脑转移瘤的瘤周水肿带的ADC值(1.83×10^(-3)±0.13)×10^(-2)mm^(2)/s及rADC值(2.39×10^(-3)±0.21)×10^(-2)mm^(2)/s;高级别胶质瘤瘤周水肿区ADC值(1.35×10^(-3)±0.16)×10^(-2)mm^(2)/s及rADC值(1.83×10^(-3)±0.13)×10^(-2)mm^(2)/s,差异有统计学意义(P<0.05);结论以T2-FLAI R增强序列为参照测量高级别胶质瘤及脑转移瘤的瘤周水肿的ADC值及rADC值能有效鉴别两种肿瘤。

Objective To investigate the value of ADC value and rADC value in the near peritumoral edema area to identify intracerebral metastases and high-grade glioma,using enhanced T2-FLAIR sequence as a reference;Methods 34 cases of high-grade glioma and 30 cases of brain metastases were collected,and the ADC value was measured within 1 cm of the peritumoral area as the ROI(Regions of interest),and the corresponding rADC value was calculated.The area of interest within 1 cm was used as the ROI(Regions of interest)to measure the ADC value and calculate the corresponding rADC value.Routine T1 enhancement,T2-FLAIR enhancements and DWI examinations were performed in all cases.Results The ADC and rADC values of the peritumoral edema zone of brain metastases were(1.83×10^(-3)±0.13)×10^(-2)mm^(2)/s and(2.39×10^(-3)±0.21)×10^(-2)mm^(2)/s;the ADC and rADC values of the peritumoral edema zone of high-grade glioma were(1.35×10^(-3)±0.16)×10^(-2)mm^(2)/s、(1.83×10^(-3)±0.13)×10^(-2)mm^(2)/s.The differences were statistically significant(P<0.05);Conclusion The ADC and rADC values of peritumoral edema of high-grade glioma and brain metastases measured with reference to T2-FLAIR enhancement sequence can effectively identify the two tumors,and the accuracy obtained with reference to T1 enhancement is comparable,suggesting that the effect of using T2-FLAIR enhancement sequence and T1 enhancement sequence as reference is comparable to that of T1 enhancement sequence.The ADC values of peritumoral edema of both tumors were measured with T2-FLAIR enhancement sequences or with T1 enhancement sequences complementing each other.