本文選題：表觀擴散系數(shù)　切入點：磁共振成像　出處：《放射學實踐》2017年04期

【摘要】：目的:探討表觀擴散系數(shù)(ADC)及rADC值對小腦半球原發(fā)性中樞神經(jīng)系統(tǒng)淋巴瘤(PCNSL)和單發(fā)轉(zhuǎn)移瘤的鑒別診斷價值。方法:回顧性分析經(jīng)手術病理證實的位于小腦半球的12例PCNSLs和15例實性單發(fā)轉(zhuǎn)移瘤患者的病例資料,所有患者均行常規(guī)MRI平掃、增強掃描及DWI檢查。測量腫瘤實質(zhì)區(qū)及對側(cè)對稱區(qū)域的平均ADC值,計算兩者的比值(rADC),并采用兩獨立樣本t檢驗比較2組患者間的差異。采用受試者工作特征曲線(ROC)分析rADC值的診斷效能。結(jié)果:PCNSLs在DWI上呈高信號11例、等信號1例,ADC均值為(0.62±0.11)×10~(-3)mm~2/s,rADC為0.93±0.15。單發(fā)轉(zhuǎn)移瘤在DWI上表現(xiàn)為高信號11例、等或低信號4例,ADC均值為(0.76±0.18)×10~(-3)mm~2/s,rADC為1.13±0.26。兩組間腫瘤的平均ADC及rADC值的差異有統(tǒng)計學意義(t=-2.12,P0.05;t=-2.50,P0.05)。以rADC值1.17為閾值時,鑒別PCNSL和單發(fā)轉(zhuǎn)移瘤的敏感度為46.7%,特異度為100%,符合率為70.4%。結(jié)論:ADC及rADC值在小腦半球原發(fā)性中樞神經(jīng)系統(tǒng)淋巴瘤與單發(fā)轉(zhuǎn)移瘤的鑒別診斷中具有重要參考價值,可提高診斷準確性。
[Abstract]:Objective: to evaluate the value of apparent diffusion coefficient (ADCC) and rADC in differential diagnosis of primary central nervous system lymphoma (PCNS) and single metastases in the cerebellar hemisphere.Methods: the data of 12 cases of PCNSLs and 15 cases of solid single metastatic tumor confirmed by operation and pathology in cerebellar hemisphere were analyzed retrospectively. All patients underwent routine MRI plain scan, enhanced scan and DWI examination.The mean ADC values of tumor parenchyma and contralateral symmetric region were measured, and the ratio of the two were calculated. The difference between the two groups was compared by two independent samples t test.The diagnostic efficacy of rADC value was analyzed by using the operating characteristic curve of subjects.Results the mean value of DWI was 0.62 鹵0.11 in 1 case and 0.93 鹵0.15 in 1 case.On DWI, 11 cases of single metastatic tumor showed hyperintense signal, and the mean value of iso-or hypointense 4 cases was 0.76 鹵0.18) 脳 10 ~ (-1) ~ (-3) mm ~ (-3) / s ~ (-1) / s ~ (r) ADC = 1.13 鹵0.26.The difference of average ADC and rADC between the two groups was statistically significant.When the threshold value of rADC was 1.17, the sensitivity of differentiating PCNSL from single metastatic tumor was 46.7, the specificity was 100, and the coincidence rate was 70.4.Conclusion the ratio of rADC and the ratio of rADC are valuable in the differential diagnosis of primary central nervous system lymphoma and single metastases in the cerebellar hemisphere and can improve the diagnostic accuracy.
【作者單位】： 鄭州大學第一附屬醫(yī)院磁共振科;
【分類號】：R445.2;R739.4

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