增强T_(2)-FLAIR为参照测量瘤周水肿ADC值在原发性中枢神经系统淋巴瘤与高级别胶质瘤中的鉴别诊断价值

The Value of Enhanced T_2-FLAIR ADC in the Differential Diagnosis of Primary Central Nervous System Lymphoma and High-grade Glioma

目的 探讨以增强T_(2)-FLAIR为参照,测量瘤周水肿ADC值在原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)与高级别胶质瘤(high-grade glioma,HGG)中的鉴别诊断价值。方法 回顾性纳入经病理证实的16例PCNSL和34例HGG患者,用独立样本t检验比较组间年龄。以增强T2-FLAIR为参照,测量瘤周水肿区的表观扩散系数(appaernt diffusion coefficient,ADC)值,绘制受试者操作特征曲线(receiver operating chara cteristic curve,ROC)分析ADC值在两者鉴别诊断中的效能。结果 两组间年龄差异无统计学意义(t=-0.726,P>0.05)。瘤周水肿区的ADC值差异有统计学意义(P<0.01),且PCNSL瘤周水肿ADC值[(1.60±0.24)×10^(-3)mm^(2)/s]高于HGG[(1.34±0.16)×10^(-3)mm^(2)/s](t=-4.438,P=0.000)。ROC曲线下面积为0.809mm^(2),最佳截断点ADC值为1.54×10^(3)mm^(2)/s,其灵敏度和特异度分别为75%和93.7%。结论以增强T_(2)-FLAIR为参照测量的瘤周水肿ADC值可有效鉴别PCN S L与HGG。

Objective To investigate the valuation of ADC value of peritumoral edema area in differentiating primary central nervous system lymphoma(PCNSL)from high-grade glioma(HGG)referring to enhanced T_(2)-FLAIR.Methods In this study,16 patients with PCNSL and 34 patients with HGG confirmed by pathology were retrospectively included.Independent sample t-test was used to compare the age between the two groups.Apparent diffusion coefficient(ADC) value was measured in the peritumoral edema area referring to enhanced T_(2)-FLAIR.Receiver operator characteristiccurve(ROC) curve was used to analyze the differential diagnosis valuation of ADC value.Results There was no statistically significant difference between the age of PCNSL and HGG(t=-0.726,P>0.05).There was statistically significant difference between the ADC value in peritumoral edema area of two groups(P<0.01).The ADC value of PCNSL [(1.60±0.24) ×10^(-3)mm^(2)/s] was higher than that of HGG[(1.34±0.16) ×10^(-3)mm^(2)/s](t=-4.438,P=0.000).The area under ROC curve was 0.809mm^(2),with 1.54×10^(3)mm^(2)/s as cut-off value,the sensitivity,specificity were 75%,93.7%,respectively.Conclusion The ADC values of peritumoral edema area referring to enhanced T_2-FLAIR can effectively differentiate PCNSL from HGG.