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表观扩散系数计算在恶性脑肿瘤鉴别与分级中的磁共振成像附加值。

The added value of the apparent diffusion coefficient calculation to magnetic resonance imaging in the differentiation and grading of malignant brain tumors.

作者信息

Bulakbasi Nail, Guvenc Inanc, Onguru Onder, Erdogan Ersin, Tayfun Cem, Ucoz Taner

机构信息

Department of Radiology, Gulhane Military Medical Academy, Etlik, 06018 Ankara, Turkey.

出版信息

J Comput Assist Tomogr. 2004 Nov-Dec;28(6):735-46. doi: 10.1097/00004728-200411000-00003.

Abstract

OBJECTIVE

ADC calculation can improve the diagnostic efficacy of MR imaging in brain tumor grading and differentiation.

METHODS

Apparent diffusion coefficient (ADC) values and ratios of 33 low-grade (23 astrocytomas, 10 oligodendrogliomas) and 40 high-grade (25 metastases and 15 high-grade astrocytomas) malignant tumors were prospectively evaluated.

RESULTS

Tumoral ADC values (r=-0.738, P <0.000) and ratios (r=-0.746, P < 0.000) were well correlated with higher degree of malignancy and quite effective in grading of malignant brain tumors (P < 0.000). By using cutoff values of 0.99 for tumoral ADC value and 1.22 for normalized ADC ratio, the sensitivity of MR imaging could be increased from 72.22% to 93.75% and 90.63%, the specificity from 81.08% to 92.68% and 90.24%, PPV from 78.79% to 90.91% and 87.88%, and NPV from 75.00% to 95.00% and 92.50%, respectively.

CONCLUSION

ADC calculation was quite effective in grading of malignant brain tumors but not in differentiation of them and added more information to conventional contrast-enhanced MR imaging.

摘要

目的

表观扩散系数(ADC)计算可提高磁共振成像(MR成像)在脑肿瘤分级和鉴别诊断中的效能。

方法

前瞻性评估了33例低级别(23例星形细胞瘤、10例少突胶质细胞瘤)和40例高级别(25例转移瘤和15例高级别星形细胞瘤)恶性肿瘤的表观扩散系数(ADC)值及比值。

结果

肿瘤ADC值(r = -0.738,P <0.000)和比值(r = -0.746,P <0.000)与更高的恶性程度密切相关,在恶性脑肿瘤分级中相当有效(P <0.000)。采用肿瘤ADC值的截断值0.99和标准化ADC比值的截断值1.22,MR成像的敏感性可分别从72.22%提高到93.75%和90.63%,特异性从81.08%提高到92.68%和90.24%,阳性预测值从78.79%提高到90.91%和87.88%,阴性预测值从75.00%提高到95.00%和92.50%。

结论

ADC计算在恶性脑肿瘤分级中相当有效,但在鉴别诊断中无效,且为传统的对比增强MR成像增加了更多信息。

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