目的：探讨磁共振扩散峰度成像（DKI）中的多个参数（MK值、MD值和FA值）在鉴别脑内原发性高级别胶质瘤与单发脑实质内转移瘤的价值。方法：收集2013年1月—2015年5月在我院就诊并经病理确诊的高级别胶质瘤13例，颅内单发转移瘤12例。所有患者均采用常规MRI序列及DKI序列，在肿瘤实质部分及肿瘤周围水肿区分别设置感兴趣区，测量其MK值、MD值和FA值，并与对侧正常脑白质进行标准化校正处理，得到相应标准化参数值MK’值、MD’值、FA’值，采用独立样本t检验对高级别胶质瘤、转移瘤两组中实质区和瘤周区的DKI各参数值进行统计学分析。结果：高级别胶质瘤的肿瘤实质区和瘤周区MK值、MD值和FA值分别为0.84±0.21、（1.28±.30）×10-3 mm2/s、0.26±0.17；1.19±0.26、（1.07±0.22）×10-3 mm2/s、0.28±0.12。颅内不典型转移瘤的肿瘤实质区和瘤周区的MK值、MD值和FA值分别为0.80±0.20、（1.48±0.45）×10-3 mm2/s、0.17±0.12；0.86±0.18、（1.54±0.46）×10-3 mm2/s、0.22±0.14。肿瘤实质区的DKI参数值在胶质瘤和转移瘤间差异无统计学意义，瘤周区MK值和MD值在两者间差异有统计学意义（P均<0.05），FA值差异无统计学意义。矫正后的MK’值、MD’值在瘤周区两种肿瘤间具有明显差异（P均<0.01），其他矫正后参数均未发现统计学差异。结论：瘤周水肿区MK值、MD值在鉴别高级别胶质瘤与脑转移瘤中具有重要的价值。

Abstract: Objective: To investigate the value of magnetic resonance diffusion kurtosis imaging(DKI) in differential diagnosis of intracerebral primary high-grade gliomas and single intracerebral metastasis tumor through multiple parameters including MK value, MD value and FA value. Methods: Thirteen cases of high-grade gliomas and 12 cases of single intracerebral metastasis tumors confirmed by pathology were collected from January 2013 to May 2015. All patients underwent conventional MRI sequences and DKI sequence. Region of interest was located at both the solid area and the surrounding edema zone of the tumors respectively, and MK, MD, FA values were measured. Standardized corrections were performed for contralateral normal brain white matter. Then corresponding standard parameters of MK’, MD’, and FA’ values were obtained. Independent samples t test was performed to compare DKI parameters of both solid area and edema region for high grade gliomas and metastasis tumors. Results: MK, MD and FA values in the solid area and surrounding region of high grade glioma tumor were 0.84±0.21, (1.28±.30)×10-3 mm2/s, 0.26±0.17; 1.19±0.26, (1.07±0.22)×10-3 mm2/s, 0.28±0.12 respectively. The DKI values of above-mentioned regions of intracranial atypical metastases were 0.80±0.20, (1.48±0.45)×10-3 mm2/s, 0.17±0.12; 0.86±0.18, (1.54±0.46)×10-3 mm2/s, 0.22±0.14 respectively. There was no statistical difference for DKI parameters of the solid region between gliomas and metastasis. There was significant difference for MK and MD values of the surrounding region between gliomas and metastasis(P<0.05), however there was no significant difference for the FA value. After the correction, there was significant difference for the MK’, MD’ values of surrounding region between two kinds of tumors(P<0.01), and there was no statistical difference for other corrected parameters. Conclusion: The MK and MD values of surrounding edema region have important value in differential diagnosis of high-grade gliomas and cerebral metastasis.