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目的探讨多b值扩散加权成像(DWI)对高级别胶质瘤和脑转移瘤的鉴别价值。方法对13例高级别胶质瘤和17例脑转移瘤患者进行常规MR及多b值DWI检查,测量肿瘤实质区及瘤周水肿区的D值及D*值,比较肿瘤实质区与瘤周水肿区之间D值及D*值的差异及两种肿瘤之间的差异,并采用t检验。结果脑转移瘤的肿瘤实质区与瘤周水肿区的D值分别为0.94±0.27和1.28±0.40(t=-2.93,P=0.006);D*值分别为5.85±1.57和4.24±1.27(t=3.28,P=0.002)。高级别胶质瘤的肿瘤实质区与瘤周水肿区的D值分别为0.85±0.21和1.20±0.37(t=-2.97,P=0.027);D*值分别为7.44±2.04和4.59±1.22(t=4.316,P=0.004)。脑转移瘤肿瘤实质区的D*平均值为5.85×10-3mm2/s,而高级别胶质瘤肿瘤实质区D*平均值为7.44×10-3mm2/s,两者间差异显著(t=-2.412,P=0.023)。肿瘤实质区的D值、瘤周水肿区D及D*值在两种肿瘤间差异均无统计学意义(P>0.05)。结论多b值DWI可以成为脑转移瘤与高级别胶质瘤无创性的鉴别方法。
Objective To investigate the differential value of multi-b diffusion weighted imaging (DWI) in high-grade gliomas and brain metastases. Methods Thirteen patients with high-grade gliomas and 17 patients with brain metastases underwent routine MR and multi-b-value DWI examinations. The D values and D * values of the tumor parenchyma and peritumoral edema area were measured. Differences in D values and D * values between edema areas and differences between the two tumors were compared using t test. Results The D values of tumor metastasis and peritumoral edema were 0.94 ± 0.27 and 1.28 ± 0.40 (t = -2.93, P = 0.006), respectively. The D * values were 5.85 ± 1.57 and 4.24 ± 1.27 (t = 3.28, P = 0.002). The values of D in high grade gliomas were 0.85 ± 0.21 and 1.20 ± 0.37 (t = -2.97, P = 0.027), respectively; the D * values were 7.44 ± 2.04 and 4.59 ± 1.22 t = 4.316, P = 0.004). The average value of D * was 5.85 × 10-3mm2 / s in the parenchyma of brain metastases and 7.44 × 10-3mm2 / s in the parenchyma of high grade gliomas, the difference was significant (t = -2.412, P = 0.023). There was no significant difference in D value between tumor parenchyma, D and D * value in peritumoral edema between the two tumors (P> 0.05). Conclusions Multi-b value DWI can be a noninvasive method for differentiating brain metastases from high-grade gliomas.