摘要
目的：表观扩散系数（Apparent diffusion coefficient，ADC）能反映肿瘤细胞的微观状态，本文探讨其对小脑原发肿瘤的诊断价值。方法：对44例经手术病理证实的小脑原发肿瘤的MRI资料进行回顾性分析，包括11例血管母细胞瘤，12例毛细胞型星形细胞瘤，11例髓母细胞瘤，6例室管膜瘤，2例淋巴瘤，2例脉络丛乳头状瘤。全部病例均行MRI常规扫描，弥散加权成像（Diffusion-weighted imaging，DWI）及ADC值测量，对前4种肿瘤的绝对ADC值、相对ADC值在Stata 9.0上进行单因素方差分析及Bonferronit t检验。结果：不同肿瘤间的绝对ADC值及相对ADC值均有差异（P<0.001），血管母细胞瘤的ADC值[（1.97±0.214)×10-3mm2/s）]要明显高于毛细胞型星形细胞瘤[（1.643±0.223）×10-3mm2/s]（P=0.001），髓母细胞瘤的ADC值[（0.698±0.124）×10-3mm2/s]明显低于室管膜瘤[（1.062±0.148）×10-3mm2/s]（P=0.003），毛细胞型星形细胞瘤则明显高于室管膜瘤（P<0.001）；脉络丛乳头状瘤亦有较高的ADC值，而淋巴瘤有较低的ADC值。在髓母细胞瘤、室管膜瘤、毛细胞型星形细胞瘤及血管母细胞瘤这4种肿瘤中，取<0.8×10-3mm2/s、（0.9～1.2）×10-3mm2/s、（1.3～1.7）×10-3mm2/s、>2.1×10-3mm2/s分别作为上述肿瘤的ADC值的界值时，可获得100%的特异性。结论：ADC值是诊断小脑肿瘤的简便而实用的工具。
Abstract
Objective: Apparent diffusion coefficient(ADC) can reflect the micro status of tumor cell， this study is to discuss the value of ADC in primary cerebellar tumor. Methods: Forty-four patients with histologically proved primary cerebellar tumor were reviewed retrospectively. There were 11 heamangioblastoma, 12 pilocytic astrocytomas, 11 medulloblastomas, 6 ependymomas, 2 lymphoma and 2 choroid plexus papillomas. All patients were examined by conventional MRI; DWI; and ADC value obtained from ADC maps. Absolute ADC values and ADC ratios of heamangioblastoma, pilocytic astrocytomas, medulloblastomas, ependymomas were calculated and compared by using one-way analysis of variance and Bonferronit t test. Results: The differences of both absolute ADC value and ADC ratio were significant among these 4 tumor types. ADC values were significantly higher in heamangioblastomas[(1.97±0.214)×10-3mm2/s] than in pilocytic astrocytomas[(1.643±0.223)×10-3mm2/s](P=0.001), ADC values in medulloblastomas[(0.698±0.124)×10-3mm2/s] were significantly lower than in ependymomas[(1.062±0.148)×10-3mm2/s](P=0.003). And pilocytic astrocytomas demonstrated significantly higher ADC values than ependymomas(P<0.001). Our cut off values of <0.8×10-3mm2/s, (0.9～1.2)×10-3mm2/s, (1.3～1.7)×10-3mm2/s, >2.1×10-3mm2/s for medulloblastomas, ependymomas, pilocytic astrocytomas and heamangioblastomas respectively were 100% specific. Conclusion: ADC value is an easy and useful tool in diagnosing primary cerebellar tumor.
关键词
小脑肿瘤 /
磁共振成像
Key words
Cerebellar neoplasms /
Magnetic resonance imaging
林 帆;李扬彬.
表观扩散系数在诊断小脑原发肿瘤的应用价值[J]. 中国临床医学影像杂志. 2008, 19(5): 315-318
LIN Fan;LI Yang-bin.
Value of apparent diffusion coefficient in diagnosing primary cerebellar tumor[J]. Journal of China Clinic Medical Imaging. 2008, 19(5): 315-318
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