CAJ | 학술논문

目的：探讨扩散张量成像（ DTI ）在鉴别不同病理类型的星形细胞肿瘤中的价值。方法：收集67例不同病理类型星形细胞肿瘤患者，所有病例均行 T1WI、T2WI、FLAIR、T1WIGd-DTPA 增强扫描和 DTI 检查，均经病理证实。分别测量肿瘤瘤实质区与正常脑白质区的 ADC 值，分析比较不同病理类型星形细胞肿瘤实质区和健侧正常脑白质区 ADC 值，用统计学软件 SPSS 19．0分别对 ADC 值进行统计学分析，统计结果均以 x ± s表示，P ＜0．05为差异有统计学意义。结果：纤维型星形细胞瘤、肥胖细胞型星形细胞瘤、间变性星形细胞瘤及巨细胞型胶质母细胞瘤肿瘤实质区、健侧正常脑白质区 ADC 值（＜10-9 mm2/s）分别为（1．48±0．12、0．72±0．05）、（1．31±0．07、0．69±0．03）、（1．06±0．11、0．71±0．04）、（0．98±0．09、0．73±0．04）。纤维型星形细胞瘤与肥胖细胞型星形细胞瘤肿瘤实质区 ADC 值比较有统计学差异（P ＜0．001）；纤维型星形细胞瘤和肥胖细胞型星形细胞瘤与间变性星形细胞瘤肿瘤和巨细胞型胶质母细胞瘤肿瘤实质区 ADC 值比较均有显著统计学差异（P ＜0．001）；间变性星形细胞瘤与巨细胞型胶质母细胞瘤肿瘤实质区ADC 值比较无统计学差异（P ＝0．07＞0．05）。结论：测量肿瘤实质区 ADC 值可鉴别不同病理类型的星形细胞肿瘤，但是难以区分间变性星形细胞瘤和巨细胞型胶质母细胞瘤；DTI 对星形细胞肿瘤术前评价有较高的实践价值。
목적：탐토확산장량성상（ DTI ）재감별불동병리류형적성형세포종류중적개치。방법：수집67례불동병리류형성형세포종류환자，소유병례균행 T1WI、T2WI、FLAIR、T1WIGd-DTPA 증강소묘화 DTI 검사，균경병리증실。분별측량종류류실질구여정상뇌백질구적 ADC 치，분석비교불동병리류형성형세포종류실질구화건측정상뇌백질구 ADC 치，용통계학연건 SPSS 19．0분별대 ADC 치진행통계학분석，통계결과균이 x ± s표시，P ＜0．05위차이유통계학의의。결과：섬유형성형세포류、비반세포형성형세포류、간변성성형세포류급거세포형효질모세포류종류실질구、건측정상뇌백질구 ADC 치（＜10-9 mm2/s）분별위（1．48±0．12、0．72±0．05）、（1．31±0．07、0．69±0．03）、（1．06±0．11、0．71±0．04）、（0．98±0．09、0．73±0．04）。섬유형성형세포류여비반세포형성형세포류종류실질구 ADC 치비교유통계학차이（P ＜0．001）；섬유형성형세포류화비반세포형성형세포류여간변성성형세포류종류화거세포형효질모세포류종류실질구 ADC 치비교균유현저통계학차이（P ＜0．001）；간변성성형세포류여거세포형효질모세포류종류실질구ADC 치비교무통계학차이（P ＝0．07＞0．05）。결론：측량종류실질구 ADC 치가감별불동병리류형적성형세포종류，단시난이구분간변성성형세포류화거세포형효질모세포류；DTI 대성형세포종류술전평개유교고적실천개치。
Objective To determine whether the different pathological types of astrocytic tumours can be differentiated by diffusion tensor MR imaging. Methods In this study, diffusion tensor MR imaging was performed preoperatively in 67 patients with different pathological types of astrocytic tumours. Furthermore , T1WI, T2WI, FLAIR and T1WI enhancement scanning by GD-DTPA were performed preoperatively in all patients. The Mean diffusivity (ADC) values in the tumor parenchyma and normal white matter from different pathological types of astrocytic tumours were measured and analyzed. The ADC with the tumor parenchyma and normal white matter from the tumours were statistically analyzed by SPSS 19.0. The results were expressed as ± s and P < 0.05 was regarded as statistically significant differences. Results There were many differences with ADC (< 10-9 mm2/s) in the tumor parenchyma between fibrillary astrocytoma (1.48 ± 0.12、0.72 ± 0.05) from fat cell astrocytoma (1.31 ± 0.07, 0.69 ± 0.03), There were also many differences with ADC ( < 10-9 mm2/s) in the tumor parenchyma between fibrillary and fat cell astrocytoma from anaplastic astrocytoma (1.06 ± 0.11, 0.71 ± 0.04) and giant cell glioblastoma (0.98 ± 0.09, 0.73 ± 0.04). There were not differences with ADC in the tumor parenchyma between anaplastic astrocytoma from giant cell gliobastona. Conclusion Measurement of tumor parenchyma′s ADC values can identify different pathological types of astrocytic tumours , but not between anaplastic astrocytoma and giant cell glioblastoma. DTI is essential to preoperative evalution of astrocytic tumours.