本文選題：原發(fā)性腦淋巴瘤 + 高級(jí)別膠質(zhì)瘤��； 參考：《臨床放射學(xué)雜志》2017年09期

【摘要】：目的探討MRI圖像紋理分析對(duì)鑒別原發(fā)性腦淋巴瘤與高級(jí)別膠質(zhì)瘤(HGG)的臨床應(yīng)用價(jià)值。方法回顧性分析經(jīng)病理證實(shí)的15例原發(fā)性腦淋巴瘤與18例HGG患者的MRI表現(xiàn),并對(duì)T1WI增強(qiáng)圖像進(jìn)行紋理分析,分別得到熵值、偏度、峰度及異質(zhì)性等相關(guān)參數(shù)。結(jié)果原發(fā)性腦淋巴瘤好發(fā)于深部腦組織,如胼胝體區(qū)、額葉及基底節(jié)區(qū),在MRI表現(xiàn)為T(mén)1WI呈等、低信號(hào),T2WI呈等、稍高信號(hào),邊界較清,增強(qiáng)后多呈均勻明顯強(qiáng)化;HGG在MRI表現(xiàn)為T(mén)1WI呈低信號(hào),T2WI呈高信號(hào),增強(qiáng)掃描后呈明顯不均勻強(qiáng)化,病灶內(nèi)部多伴有囊變、壞死及出血成分。原發(fā)性腦淋巴瘤與HGG比較,多發(fā)病灶、強(qiáng)化方式和累及中線特征在統(tǒng)計(jì)學(xué)上存在顯著差異(P0.05);紋理分析腦淋巴瘤組和HGG組中T1WI增強(qiáng)圖像,腦淋巴瘤組的熵值與異質(zhì)性參數(shù)低于HGG組的熵值與異質(zhì)性參數(shù),兩者在統(tǒng)計(jì)學(xué)上存在顯著差異(P0.05)。同時(shí),紋理分析異質(zhì)性參數(shù)明顯優(yōu)于熵值;當(dāng)異質(zhì)性參數(shù)Cut-off點(diǎn)取0.175時(shí),鑒別診斷腦淋巴瘤與HGG的敏感性、特異性和準(zhǔn)確性分為86.7%、94.4%和90.9%。結(jié)論紋理分析的熵值、異質(zhì)性參數(shù)結(jié)合常規(guī)MRI平掃和增強(qiáng)表現(xiàn),對(duì)鑒別原發(fā)性腦淋巴瘤與HGG具有一定的臨床應(yīng)用價(jià)值。
[Abstract]:Objective to evaluate the clinical value of MRI texture analysis in differentiating primary brain lymphoma from high grade glioma. Methods the MRI findings of 15 cases of primary brain lymphoma and 18 cases of HGG were analyzed retrospectively. The entropy, deviation, kurtosis and heterogeneity were obtained by texture analysis of T1WI enhanced images. Results Primary brain lymphoma was found in deep brain tissues, such as corpus callosum, frontal lobe and basal ganglia. On MRI, T1WI was isotropic, hypointensity was isobaric on T2WI, and the boundary was clear. On MRI, T1WI showed low signal intensity on T _ 2WI and obvious non-uniform enhancement after contrast enhancement. The lesions were often accompanied with cysts, necrosis and bleeding components. Compared with HGG, there were statistically significant differences in multiple lesions, enhancement mode and involvement midline between primary brain lymphoma and HGG. T1WI enhanced images in brain lymphoma group and HGG group were analyzed by texture analysis. The entropy value and heterogeneity parameter of brain lymphoma group were lower than that of HGG group, and there was significant difference between them (P 0.05). At the same time, the heterogeneity parameters of texture analysis were obviously superior to entropy value, and when the heterogeneity parameter Cut-off was 0.175, the sensitivity, specificity and accuracy of differential diagnosis of brain lymphoma and HGG were 86.7% and 90.9%, respectively. Conclusion the entropy and heterogeneity parameters of texture analysis combined with conventional MRI plain scan and enhancement are valuable in differentiating primary brain lymphoma from HGG.
【作者單位】： 徐州醫(yī)科大學(xué)附屬醫(yī)院影像科;
【分類號(hào)】：R445.2;R739.41

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