CAJ | 학술논문

目的：探讨磁共振扩散加权成像(DWI)的表观扩散系数(ADC)值在鉴别脑结核瘤与脑转移瘤的诊断价值。方法对24例临床确诊的脑结核瘤(非成熟型结核瘤18例、成熟型结核瘤6例)和36例脑转移瘤患者进行常规 MRI 平扫、增强扫描及 DWI 扫描。观察疾病常规 MR 影像特点,分别测量病灶内强化区域、非强化区域及病灶周围水肿带的平均 ADC 值和对侧相应部位正常脑白质区 ADC 值,并以对侧正常脑白质区 ADC 值为标准,分别计算相对 ADC 值(rADC 值)。结果非成熟型脑结核瘤、成熟型脑结核瘤与脑转移瘤强化区域平均 ADC 值(分别为796.90×10-6 mm2/s、791.95×10-6 mm2/s、421.95×10-6 mm2/s)及 rADC 值(分别为1.16、1.16、0.61)存在显著性差异(ADC：H =42.293、P ≤0.05,rADC：H =42.575,P ≤0.05)；非强化区域 ADC 值(分别为864.85×10-6 mm2/s、611.80×10-6 mm2/s、961.00×10-6 mm2/s)及 rADC 值(分别为1.27、0.87、1.36)存在显著性差异(ADC：H =33.100、P ≤0.05；rADC：H =17.867,P ≤0.05)；病灶周围水肿带的 ADC 值(分别为1531.60×10-6 mm2/s、1488.45×10-6 mm2/s、1545.00×10-6 mm2/s)值及 rADC 值(2.24、2.10、2.18)无显著性差异(ADC：H =1.550、P ≥0.05；rADC：H =5.511, P ≥0.05)。结论结合常规 MRI 平扫及增强扫描,DWI 检查中的 ADC 值有助于鉴别脑结核瘤和脑转移瘤。
목적：탐토자공진확산가권성상(DWI)적표관확산계수(ADC)치재감별뇌결핵류여뇌전이류적진단개치。방법대24례림상학진적뇌결핵류(비성숙형결핵류18례、성숙형결핵류6례)화36례뇌전이류환자진행상규 MRI 평소、증강소묘급 DWI 소묘。관찰질병상규 MR 영상특점,분별측량병조내강화구역、비강화구역급병조주위수종대적평균 ADC 치화대측상응부위정상뇌백질구 ADC 치,병이대측정상뇌백질구 ADC 치위표준,분별계산상대 ADC 치(rADC 치)。결과비성숙형뇌결핵류、성숙형뇌결핵류여뇌전이류강화구역평균 ADC 치(분별위796.90×10-6 mm2/s、791.95×10-6 mm2/s、421.95×10-6 mm2/s)급 rADC 치(분별위1.16、1.16、0.61)존재현저성차이(ADC：H =42.293、P ≤0.05,rADC：H =42.575,P ≤0.05)；비강화구역 ADC 치(분별위864.85×10-6 mm2/s、611.80×10-6 mm2/s、961.00×10-6 mm2/s)급 rADC 치(분별위1.27、0.87、1.36)존재현저성차이(ADC：H =33.100、P ≤0.05；rADC：H =17.867,P ≤0.05)；병조주위수종대적 ADC 치(분별위1531.60×10-6 mm2/s、1488.45×10-6 mm2/s、1545.00×10-6 mm2/s)치급 rADC 치(2.24、2.10、2.18)무현저성차이(ADC：H =1.550、P ≥0.05；rADC：H =5.511, P ≥0.05)。결론결합상규 MRI 평소급증강소묘,DWI 검사중적 ADC 치유조우감별뇌결핵류화뇌전이류。
Objective To explore the value of apparent diffusion coefficient (ADC)in differentiating brain tuberculomas from me-tastases.Methods Conventional and enhanced MRI as well as diffusion weighted imaging (DWI)were performed in 24 cases of brain tuberculomas(immature in 18 cases and mature in 6 case)and 36 cases of metastases.The mean ADC values and relative ADC (rADC)values were calculated from the enhanced and non-enhanced regions of mass and the peripheral edema regions of brain le-sions.Results The mean ADC values and rADC values in the enhanced,non-enhanced and the peripheral edema regions were 796.90×10 -6 mm2/s and 1.1 6,864.85×10 -6 mm2/s and 1.27,1 531.60×10 -6 mm2/s and 2.24 for the immature brain tuberculo-mas;791.95×10 -6 mm2/s and 1.1 6,61 1.80×10 -6 mm2/s and 0.87,and 1 488.45×10 -6 mm2/s and 2.10 for the mature tubercu-lomas;421.95×10 -6 mm2/s and 0.61,961.00×10 -6 mm2/s and 1.36,1 545.00×10 -6 mm2/s and 2.18 for the brain metastases, respectively.There were significant differences in the mean ADC values (H =42.293,P ≤0.05)and rADC values (H =42.575, P ≤0.05)for the enhance regions in the three groups .There were also significant differences in the mean ADC values (H =33.100, P ≤0.05)and rADC values (H =1 7.867,P ≤0.05)for the non-enhance regions.No significant difference in the mean ADC values (H =1.550,P ≥0.05)and rADC values (H =5.511,P ≥0.05)were found for the peripheral edema regions.Conclusion The ADC values of DWI can help to differentiate brain tuberculomas from metastases,when combining with the conventional and enhanced MRI.