脑部扩散加权回波平面磁共振成像及计算所得的表观扩散系数：鉴别肿瘤坏死与脓肿的有用工具？
Diffusion-weighted echo-planar MRI of the brain with calculated ADCs: a useful tool in the differential diagnosis of tumor necrosis from abscess?
作者信息
Dorenbeck U, Butz B, Schlaier J, Bretschneider T, Schuierer G, Feuerbach S
机构信息
Department of Diagnostic Radiology, University Hospital of Regensburg, Regensburg, Germany.
出版信息
J Neuroimaging. 2003 Oct;13(4):330-8.
BACKGROUND AND PURPOSE
It was the aim of this study to evaluate whether brain abscesses could be distinguished reliably from necrotic brain tumors using diffusion-weighted imaging (DWI) with calculated apparent diffusion coefficients (ADCs).
METHODS
The authors studied 27 lesions in 26 patients (21 tumors and metastases, 5 pyogenic brain abscesses, and 1 cerebral toxoplasmosis). DWI was obtained with a single-shot echo-planar imaging spin-echo sequence. ADCs were calculated for all images.
RESULTS
ADCs (x 10(-3) mm2/s) measured in the necrotic parts of the tumors ranged from 2.94 (glioblastoma) to 1.51 (astrocytoma III). In the inflammatory lesions, ADCs ranged between 0.91 and 3.07 (cerebral toxoplasmosis and pyogenic abscess). The contrast-enhanced parts of the lesions showed ADC values from 0.77 (pyogenic abscess) up to 1.68 (glioblastoma).
CONCLUSIONS
DWI with calculated ADC values does not allow the reliable differentiation of enhanced central necrotic intracranial lesions.
背景与目的
本研究旨在评估使用弥散加权成像（DWI）及计算表观扩散系数（ADC）能否可靠地区分脑脓肿与坏死性脑肿瘤。
方法
作者研究了26例患者的27个病灶（21个肿瘤和转移瘤、5个化脓性脑脓肿以及1个脑弓形虫病病灶）。采用单次激发回波平面成像自旋回波序列进行DWI检查。对所有图像计算ADC值。
结果
肿瘤坏死部分测得的ADC值（×10⁻³mm²/s）范围为2.94（胶质母细胞瘤）至1.51（三级星形细胞瘤）。在炎性病灶中，ADC值介于0.91至3.07之间（脑弓形虫病和化脓性脓肿）。病灶的强化部分显示ADC值从0.77（化脓性脓肿）至1.68（胶质母细胞瘤）不等。
结论
计算ADC值的DWI无法可靠地区分强化的颅内中央坏死性病变。
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