發(fā)布時(shí)間：2018-02-10 20:15

  本文關(guān)鍵詞： 顱內(nèi)結(jié)核 腦轉(zhuǎn)移瘤 彌散加權(quán)成像 表觀擴(kuò)散系數(shù)值　出處：《中國醫(yī)學(xué)計(jì)算機(jī)成像雜志》2017年01期 　論文類型：期刊論文

【摘要】：目的:分析腦實(shí)質(zhì)結(jié)核的MRI特點(diǎn),探討多b值彌散加權(quán)成像(DWI)對腦實(shí)質(zhì)結(jié)核與腦轉(zhuǎn)移瘤鑒別診斷的應(yīng)用價(jià)值。方法:對28例腦實(shí)質(zhì)結(jié)核和31例腦轉(zhuǎn)移瘤患者行MRI檢查和多b值DWI成像,分析兩者的MRI表現(xiàn),測量實(shí)性強(qiáng)化病灶及環(huán)形強(qiáng)化病灶的強(qiáng)化環(huán)壁、中央壞死的各類表觀擴(kuò)散系數(shù)(apparent diffusion coefficient,ADC)值,包括ADC_(10b)、ADC_(high)及ADC_(perf)值,采用兩樣本t檢驗(yàn)。結(jié)果:腦實(shí)質(zhì)結(jié)核337個(gè)病灶,實(shí)性均勻強(qiáng)化病灶102個(gè),69.6%≤3.0mm,25.5%在3.0~10.0mm之間;環(huán)形強(qiáng)化病灶235個(gè),環(huán)壁厚薄均勻光整,32.4%在3.5~5.0mm之間,45.5%在5.0~10.0mm之間,22.1%≥10.0mm。腦轉(zhuǎn)移瘤285個(gè),實(shí)性欠均勻強(qiáng)化病灶74個(gè),27.0%≤3.0mm,73.0%3.0mm;環(huán)形強(qiáng)化病灶211個(gè),環(huán)壁凹凸不平,84.8%5.0mm。腦實(shí)質(zhì)結(jié)核中實(shí)性強(qiáng)化結(jié)節(jié)、強(qiáng)化環(huán)壁的ADC_(high)值分別為(0.240±0.038)×10~(-3)mm~2/s、(0.249±0.039)×10~(-3)mm~2/s,均高于腦轉(zhuǎn)移瘤,腦實(shí)質(zhì)結(jié)核環(huán)形強(qiáng)化病灶干酪實(shí)性中心區(qū)的ADC_(high)值為(0.251±0.056)×10~(-3)mm~2/s,低于腦轉(zhuǎn)移瘤的中心壞死區(qū)。環(huán)形強(qiáng)化病灶中環(huán)壁的ADC_(10b)及ADC_(high)值分別以0.088×10~(-3)mm~2/s和0.241×10~(-3)mm~2/s為界,鑒別腦實(shí)質(zhì)結(jié)核與腦轉(zhuǎn)移瘤的靈敏度分別為83.9%、58.9%,特異度分別為72.5%、100%。結(jié)論:結(jié)合病灶大小、MRI強(qiáng)化方式及ADC_(high)值與ADC_(10b)值的測量有利于腦實(shí)質(zhì)結(jié)核和腦轉(zhuǎn)移瘤的鑒別診斷。
[Abstract]:Objective: to analyze the MRI features of cerebral parenchyma tuberculosis. To evaluate the value of DWI in differential diagnosis of cerebral parenchyma tuberculosis and brain metastases. Methods: 28 patients with cerebral parenchyma tuberculosis and 31 patients with brain metastases were examined by MRI and multi-b DWI imaging, and their MRI manifestations were analyzed. The enhancement ring wall of solid and annular enhancement lesions and the apparent diffusion coefficient of central necrosis were measured. The apparent diffusion coefficient of central necrosis was measured, including the value of ADCA 10 BX, ADCC high and ADCP perfuse. The results were as follows: 337 lesions of brain parenchyma tuberculosis, 102 solid homogeneous enhancement lesions (69.6% 鈮，

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