CAJ | 학술논문

目的探讨1.5T MRI在脑内环形强化病变鉴别诊断中的价值. 方法回顾性分析泰山医学院附属莱芜医院影像中心选自2009年4月至2013年3月经临床手术病理证实的,表现为环形强化的脑转移瘤、胶质瘤以及脑脓肿各40例病例的1.5T MRI表现,比较各病种的影像征象差异. 结果脑转移瘤与胶质瘤组间病灶的位置、数目、大小、形态、分房征、多发壁结节、外侧壁是否光整征象有差异;脑转移瘤与脑脓肿组间病灶的数目、大小、子母环征、环壁切迹征、环壁厚度、内侧壁是否光整、T2WI低信号环征、液液平征、病灶中心DWI高信号及ADC图低信号、灶周水肿程度征象有差异;胶质瘤与脑脓肿组间病灶的位置、形态、分房征、子母环征、多发壁结节、环壁切迹征、环壁厚度、内外侧壁是否光整、T2WI低信号环征、液液平征、病灶中心DWI高信号及ADC图低信号征象有差异.脑转移瘤的征象依次为多发病灶、灶周Ⅲ级水肿、小病灶、外侧壁光整、病灶位于皮髓质交界处,显示百分比分别为79.5％、70.3％、67.5％、48.5％、47.9％;胶质瘤的征象依次为分房征、病灶位置在髓质、多发壁结节、外侧壁不光整、病灶为不规则形,显示百分比分别为85.7％、78.0％、77.8％、65.4％、51.9％;脑脓肿的征象依次为子母环征、DWI高并ADC图低信号、环壁切迹征、T2WI低信号环征、液液平征,显示百分比分别为100％、100％、100％、92.6％、82.4％. 结论 1.5T MRI能够显示脑转移瘤、胶质瘤、脑脓肿3种病变特征性征象,对三者鉴别诊断具有重要价值.
목적 탐토1.5T MRI재뇌내배형강화병변감별진단중적개치. 방법 회고성분석태산의학원부속래무의원영상중심선자2009년4월지2013년3월경림상수술병리증실적,표현위배형강화적뇌전이류、효질류이급뇌농종각40례병례적1.5T MRI표현,비교각병충적영상정상차이. 결과 뇌전이류여효질류조간병조적위치、수목、대소、형태、분방정、다발벽결절、외측벽시부광정정상유차이;뇌전이류여뇌농종조간병조적수목、대소、자모배정、배벽절적정、배벽후도、내측벽시부광정、T2WI저신호배정、액액평정、병조중심DWI고신호급ADC도저신호、조주수종정도정상유차이;효질류여뇌농종조간병조적위치、형태、분방정、자모배정、다발벽결절、배벽절적정、배벽후도、내외측벽시부광정、T2WI저신호배정、액액평정、병조중심DWI고신호급ADC도저신호정상유차이.뇌전이류적정상의차위다발병조、조주Ⅲ급수종、소병조、외측벽광정、병조위우피수질교계처,현시백분비분별위79.5％、70.3％、67.5％、48.5％、47.9％;효질류적정상의차위분방정、병조위치재수질、다발벽결절、외측벽불광정、병조위불규칙형,현시백분비분별위85.7％、78.0％、77.8％、65.4％、51.9％;뇌농종적정상의차위자모배정、DWI고병ADC도저신호、배벽절적정、T2WI저신호배정、액액평정,현시백분비분별위100％、100％、100％、92.6％、82.4％. 결론 1.5T MRI능구현시뇌전이류、효질류、뇌농종3충병변특정성정상,대삼자감별진단구유중요개치.
Objective To evaluate the value of 1.5T MRI in differential diagnosis of circular enhanced brain lesions.Methods A total of 120 patients,admitted to our hospital from April 2009 to March 2013 and confirmed by clinical pathology,including 40 of brain metastasis,40 of astrocytoma and 40 of brain abscess,were chosen in our study; The characteristic signs of MRI findings of these patients were retrospectively analyzed.Results There were significant differences in the location,number,size,morphology,ring structure,multiple mural nodules,and smooth outside wall of the lesions between patients with brain metastasis and astrocytoma.There were significant differences in the number,size,ring structure,ring wall thickness,and smooth outside wall of the lesions,T2-weighted imaging (T2WI) low signal ring sign,hydraulic fluid level sign,lesion center diffusion weighted imaging (DWI) hyperintensity and apparent diffusion coefficient (ADC) map low signal between patients with brain metastasis and abscess.There were significant differences in the location,shape and multi locular lesions between patients with astrocytoma and abscess.The signs indicating brain metastasis included multi lesions,grade Ⅲ peripheral edema,small lesions,lesions located at the juncture of gray and white matter,with displaying percentages of 79.5％,70.3％,67.5％,48.5％ and 47.9％.The signs indicating astrocytoma included multi locular lesion,lesions located at the white matter,multi mural nodule,rough outside wall and irregular in shape,with displaying percentages of 85.7％,78.0 ％,77.8％,65.4 ％ and 51.9％.The signs indicating abscess included daughter ring sign,DWI hyperintensity and ADC map low signal,circular wall notch sign,hype-intensity rim on T2WI and fluid-fluid level,with displaying percentages of 100％,100％,100％,92.6％ and 82.4％.Conclusion The 1.5T MRI can displaythe characteristic signs of brain metastases,gliomas and brain abscess,which enjoys high value in differential diagnosis.