摘要
目的评价MRI表观扩散系数(ADC)值在儿童小脑常见后颅窝肿瘤的鉴别诊断价值。资料与方法 43例经临床治疗及手术病理证实的儿童后颅窝肿瘤患者中,髓母细胞瘤24例,毛细胞型星形细胞瘤10例,室管膜瘤9例。所有患者行常规MRI、扩散加权成像(DWI)及增强MRI检查,在重组的ADC图像上比较肿瘤实质与正常小脑实质的信号强度,定量测定肿瘤实质区的ADC值。三组肿瘤实质的ADC值比较采用Wilcoxon秩和检验。结果 ADC图像上24例髓母细胞瘤中,9例肿瘤呈低信号、12例呈略低信号、3例呈等信号;肿瘤实质的平均ADC值为(0.70±0.11)×10-3mm2/s。所有10例毛细胞型星形细胞瘤均呈高信号,肿瘤实质的平均ADC值为(1.80±0.30)×10-3mm2/s。9例室管膜瘤中,5例肿瘤呈略高信号、4例呈高信号;肿瘤实质的平均ADC值为(1.16±0.18)×10-3mm2/s。髓母细胞瘤较毛细胞型星形细胞瘤的ADC值减低,差异有统计学意义(Z=-4.54,P值(0.01)。髓母细胞瘤较室管膜瘤的ADC值减低,差异有统计学意义(Z=-4.29,P值(0.01)。毛细胞型星形细胞瘤较室管膜瘤的ADC值增高,差异有统计学意义(Z=-3.27,P值(0.05)。结论脑肿瘤实质ADC值的测量简便易行,可用于术前鉴别儿童后颅窝肿瘤,尤其有助于鉴别髓母细胞瘤和毛细胞型星形细胞瘤。
Objective To assess the utility of apparent diffusion coefficient（ADC） for differential diagnosis of common pediatric posterior possa tumors.Materials and Methods In 43 pediatric patients with surgically and pathologically confirmed posterior possa tumors,there were 24 medulloblastomas,10 pilocytic astrocytomas,and 9 ependymomas.All pediatric patients recevied conventional MRI,DWI and contrast enhanced MRI examination,the signal intensity of tumor parenchyma was compared with that of normal cerebellar parenchymas.ADC values of tumor parenchyma were measured quantitatively.ADC values of medulloblastomas,pilocytic astrocytomas,and ependymomas were compared by Wilcoxon rank sum test.Results On ADC map,In 24 patients with medulloblastomas,the tumors showed hypointense in 9 patients,slightly hypointense in 12 patients,and isointense in 3 patients;the average ADC value of tumor parenchymas was（0.70±0.11）×10-3 mm2/s.All tumors showed hyperintense in 10 patients with pilocytic astrocytoma,the average ADC value of tumor parenchymas was（1.80±0.30）×10-3 mm2/s.In 9 patients with ependymomas,the tumors showed slightly hyperintense in 5 patients,hyperintense in 4 patients;the average ADC value of tumor parenchymas was（1.16±0.18）×10-3 mm2/s.The ADC value of medulloblastoma was lower than that of pilocytic astrocytoma,which was statistically significant（Z=-4.54,P﹤0.01）.The ADC value of medulloblastoma was lower than that of ependymoma,which was statistically significant（Z=-4.29,P﹤0.01）.The ADC value of pilocytic astrocytoma was higher than that of ependymoma,which was statistically significant（Z=-3.27,P﹤0.05）.Conclusion Measurement of ADC value of cerebral tumor parenchyma is a simple and available method,which is useful for preoperative differentiation of pediatric posterior possa tumors,especially in differential diagnosis of medulloblastoma and pilocytic astrocytoma.
出处
《临床放射学杂志》
CSCD
北大核心
2011年第9期1359-1363,共5页
Journal of Clinical Radiology
基金
国家重点基础研究发展计划(973计划)项目(2006CB705707)
关键词
脑肿瘤
星形细胞瘤
髓母细胞瘤
磁共振成像
扩散加权成像
Cerebral neoplasms Astrocytoma Medulloblastoma Magnetic resonance imaging Diffusion-weighted imaging
