CAJ | 학술논문

目的探讨磁共振弥散加权成像(DWI)及表观弥散系数(ADC)在鉴别胶质瘤瘤体区、瘤周区和正常组织中的应用及鉴别胶质瘤良、恶性的价值.方法采用Philips 1.5T Achieva超导型磁共振成像仪,对46例胶质瘤患者行常规MRI及DWI,弥散系数b值分别取0和1 000 s/mm2,测量瘤体区、瘤周区及对侧正常组织的ADC值.结果胶质瘤瘤体区的DWI和ADC图信号分别高于和低于正常脑组织.Ⅰ、Ⅱ、Ⅲ、Ⅳ级胶质瘤瘤体区的ADC值为别为1.68±0.18、1.65±0.20、1.29±0.16、1.21±0.21;瘤周区的ADC值分别为1.74±0.22、1.72±0.19、1.35±0.20、1.28±0.19,与对侧正常组织相比差异有统计学意义(P＜0.05),瘤体区与瘤周区间差异无统计学意义(P＞0.05).低级(Ⅰ、Ⅱ级)胶质瘤的ADC值明显大于高级(Ⅲ、Ⅳ)胶质瘤(P＜0.05).结论 DWI、ADC图及ADC值能鉴别胶质瘤瘤体区及瘤周区与正常组织,但不能可靠地鉴别瘤体区及瘤周区.ADC值能够反映肿瘤的细胞构成,DWI对良、恶性胶质瘤的分级有较高的预测价值.
목적 탐토자공진미산가권성상(DWI)급표관미산계수(ADC)재감별효질류류체구、류주구화정상조직중적응용급감별효질류량、악성적개치.방법 채용Philips 1.5T Achieva초도형자공진성상의,대46례효질류환자행상규MRI급DWI,미산계수b치분별취0화1 000 s/mm2,측량류체구、류주구급대측정상조직적ADC치.결과 효질류류체구적DWI화ADC도신호분별고우화저우정상뇌조직.Ⅰ、Ⅱ、Ⅲ、Ⅳ급효질류류체구적ADC치위별위1.68±0.18、1.65±0.20、1.29±0.16、1.21±0.21;류주구적ADC치분별위1.74±0.22、1.72±0.19、1.35±0.20、1.28±0.19,여대측정상조직상비차이유통계학의의(P＜0.05),류체구여류주구간차이무통계학의의(P＞0.05).저급(Ⅰ、Ⅱ급)효질류적ADC치명현대우고급(Ⅲ、Ⅳ)효질류(P＜0.05).결론 DWI、ADC도급ADC치능감별효질류류체구급류주구여정상조직,단불능가고지감별류체구급류주구.ADC치능구반영종류적세포구성,DWI대량、악성효질류적분급유교고적예측개치.
Objective To evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficients (ADC) in differentiating tumor, edema, and normal brain tissue, and in classification of cerebral gliomas. Methods Using Philips Achieva 1.5T super conduct MR scanner, 46 patients with gliomas underwent conventional MR imaging and DWI. The ADC of regions of interest ( ROI ) were measured with two different b values, 0s/mm2 and 1000s/mm2. ROIs were manually placed over areas of tumor,edema, and normal brain tissue. Results The signals of DWI and ADC map in tumor tissue were respectively higher and lower than those in normal brain tissue. The ADC values in tumor were 1.68 ± 0.18,1.65 ± 0.20,1.29 ±0.16,1.21 ±0.21 for grade Ⅰ、Ⅱ、Ⅲ、Ⅳ gliomas, respectively; the corresponding figures in edema were 1.74 ±0.22,1.72 ±0.19,1.35 ±0.20,1.28 ±0.19, respective. The ADC values in tumor were not significantly different from the values in edema (P ＞0.05); however, both values were significantly different from those in normal brain ( P ＜0.05 ). The ADC value of low grade ( grade1-2 ) gliomas was significantly higher than that of high grade (grade3-4) glioma (P＜0.05). Conclusion ADC values can aid in distinguishing tumors from normal tissues, but can not distinguish tumors from adjacent edema. Individually, ADC values overlapped considerahly. ADC value is associated with cellularity of gliomas. DWI can help characterizing the malignancy of gliomas.