摘要
目的：探讨弥散张量成像FA值及ADC值在AIDS脑内机会性感染中的临床诊断价值。方法：收集经临床确诊艾滋病合并脑内结核的患者12例，弓形虫患者10例，均行常规MRI检查、DTI和T1WI增强检查，观察病变特点并测量病变实质区、周围水肿区及对侧正常区ADC值、FA值并分析其统计学差异，ROC曲线分析两值诊断效能。结果：两感染灶实质区、水肿区及正常区ADC值及FA值间均有显著差异（P＜0.05），与正常区相比，实质区、水肿区ADC值、FA值均有统计学意义（P＜0.05）；两感染灶实质区与水肿区FA值及结核性病灶实质区与水肿区ADC值均有统计学差异（P＜0.05）。两组间实质区FA值存在差异（t=-5.648，P＜0.01）。ROC曲线显示ADC值AUC=0.715，FA值AUC=0.914，FA值诊断效能大于ADC值（P＜0.05）。结论：DTI能为AIDS合并脑内结核及弓形虫感染诊断和鉴别诊断提供更多信息，为临床合理用药提供可靠依据。
Abstract
Objective: To study the clinical application of FA and ADC values in brain AIDS-associated infection. Methods: 22 subjects who suffered from AIDS(12 brain tuberculosis and 10 toxoplasmosis) were recruited to perfprm routine MRI, T1WI-CE and DTI sequences. Morphological characteristics of lesions were observed. ADC and FA values of the lesional solid areas, edematous areas and the contralateral normal areas were measured. The diagnostic efficiency of the two values were analyzed by ROC curve. Results: Significant differences of ADC and FA values were observed among the three regions between subjects with brain tuberculosis and those with toxoplasmosis(P<0.05). Compared with the contralateral normal areas, ADC and FA values of the solid areas and edematous areas in two groups showed significant differences(P<0.05). For lesional solid and edematous areas, FA values and ADC values in the the groups showed significant differences. FA values of the solid area in two groups showed significant difference(P<0.05). ROC curves showed the AUC of FA value was larger than that of ADC value(0.932 vs 0.715, respectively, P<0.05). Conclusion: DTI helps to diagnose brain tuberculosis or toxoplasmosis in AIDS patients and provides evidences for medical treatment.
关键词
结核 /
脑膜 /
获得性免疫缺陷综合征 /
弓形虫病 /
脑 /
磁共振成像 /
弥散
Key words
Tuberculosis /
meningeal /
Acquired immunodeficiency syndrome /
Toxoplasmosis /
cerebral /
Diffusion magnetic resonance imaging
褚相乐;赵丽萍;马景旭;王云玲;王 红.
FA值与ADC值在AIDS脑内结核和弓形虫中的应用[J]. 中国临床医学影像杂志. 2015, 26(5): 305-308
CHU Xiang-le;ZHAO Li-ping;MA Jing-xu;WANG Yun-ling;WANG Hong.
Application of FA and ADC values in AIDS patients with brain opportunistic infection:a comparative study of tuberculosis and toxoplasmosis[J]. Journal of China Clinic Medical Imaging. 2015, 26(5): 305-308
中图分类号：
Ｒ529.3
Ｒ531.8
R512.91
R445.2
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