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目的探讨磁共振弥散加权成像(Diffusion Weighted Image,DWI)技术对脑脓肿与脑肿瘤坏死的鉴别诊断价值。方法回顾性分析经手术或临床证实为脑肿瘤及脑脓肿,在磁共振常规图像上表现有液化区的颅脑病变24例,测量液化区的表观弥散系数(apparent diffusion coefficient,ADC)值,并进行统计学分析。结果 24例患者中,胶质瘤合并坏死10例,转移瘤合并坏死6例,脑脓肿8例,脑脓肿脓腔在DWI图像呈异常高信号,平均ADC值为(0.42±0.12)×10-3mm2/s,胶肿瘤坏死区在DWI图像呈低信号,平均ADC值为(2.33±0.36)×10-3mm2/s,脑脓肿脓腔与脑肿瘤坏死的ADC值差异具有统计学意义(t=6.652,P<0.001)。结论脑肿瘤与脑脓肿均可出现液化坏死,常规MR图像鉴别困难,磁共振DWI成像技术能够准确对脑脓肿与脑肿瘤进行鉴别。
Objective To investigate the differential diagnosis value of Diffusion Weighted Image (DWI) on brain abscess and brain tumor necrosis. Methods A retrospective analysis of 24 cases of craniocerebral lesions with liquefied areas showed by routine or clinically proven brain tumors and brain abscesses was performed. The apparent diffusion coefficient (ADC) value of the liquefied area was measured. And statistical analysis. Results Among the 24 patients, there were 10 cases of glioma complicated with necrosis, 6 cases of metastatic tumor with necrosis, 8 cases of brain abscess and abscess of brain abscess with abnormally high signal on DWI. The average ADC value was (0.42 ± 0.12) × 10- 3mm2 / s, the tumor necrosis area showed a low signal on the DWI images with an average ADC value of (2.33 ± 0.36) × 10-3mm2 / s. There was significant difference in ADC value between abscess of brain abscess and brain tumor necrosis (t = 6.652, P <0.001). Conclusion Liquefaction and necrosis may occur in both brain and brain abscess. Difficulty in identifying conventional MR images is difficult. Magnetic resonance imaging (DWI) can accurately distinguish brain abscess from brain tumor.