Seo H S, Chang K-H, Na D G, Kwon B J, Lee D H
Department of Radiology, Seoul National University School of Medicine, Seoul, Korea.
AJNR Am J Neuroradiol. 2008 Mar;29(3):458-63. doi: 10.3174/ajnr.A0842. Epub 2007 Dec 7.
High b-value diffusion-weighted imaging (DWI) provides different features not appreciated at lower b-value and have been recently studied in several clinical issues. The purpose of this study was to assess whether DWI at b = 3000 s/mm(2) is more useful in discriminating high-grade and low-grade gliomas than DWI at b = 1000 s/mm(2) at 3T.
DWIs at both b = 1000 and 3000 s/mm(2) were performed at 3T in 62 patients, 49 high-grade gliomas (20 World Health Organization [WHO] grade III and 29 grade IV) and 13 low-grade gliomas (13 grade II). Visual assessments based on 5-point scaled evaluations, receiver operating characteristic (ROC) curve analysis, and quantitative assessment based on DWI signal intensity (SI) ratio (tumor SI/normal SI) and apparent diffusion coefficient (ADC) values were compared between DWIs at b = 1000 and 3000 s/mm(2).
By visual assessment, DWI at b = 3000 s/mm(2) showed more conspicuous hyperintensity in high-grade gliomas and hypointensity in low-grade gliomas than DWI at b = 1000 s/mm(2). Sensitivity and specificity at b = 3000 s/mm(2) were higher than at b = 1000 s/mm(2) (83.7%, 84.6% vs 69.4%, 76.9%, respectively). Quantitative assessments showed that mean SI ratio of high-grade gliomas was significantly higher than that of low-grade gliomas at both b-values. The mean ADC value of high-grade gliomas was significantly lower than that of low-grade gliomas at both b-values. The difference between the SI ratios of high-grade and low-grade gliomas was significantly larger at b = 3000 s/mm(2) than at b = 1000 s/mm(2).
DWI at b = 3000 s/mm(2) is more useful than DWI at b = 1000 s/mm(2) in terms of discriminating high-grade and low-grade gliomas at 3T.
高b值扩散加权成像(DWI)具有在较低b值时无法呈现的不同特征,近期已在多个临床问题中得到研究。本研究旨在评估在3T场强下,b = 3000 s/mm²的DWI在鉴别高级别和低级别胶质瘤方面是否比b = 1000 s/mm²的DWI更具优势。
对62例患者在3T场强下进行了b = 1000和3000 s/mm²的DWI检查,其中49例为高级别胶质瘤(20例世界卫生组织[WHO]Ⅲ级和29例Ⅳ级),13例为低级别胶质瘤(13例Ⅱ级)。比较了基于5分制评估的视觉评估、受试者操作特征(ROC)曲线分析以及基于DWI信号强度(SI)比值(肿瘤SI/正常SI)和表观扩散系数(ADC)值的定量评估在b = 1000和3000 s/mm²的DWI之间的差异。
通过视觉评估,b = 3000 s/mm²的DWI在高级别胶质瘤中显示出比b = 1000 s/mm²的DWI更明显的高信号,在低级别胶质瘤中显示出更低信号。b = 3000 s/mm²时的敏感性和特异性高于b = 1000 s/mm²(分别为83.7%、84.6% vs 69.4%、76.9%)。定量评估显示,在两个b值下,高级别胶质瘤的平均SI比值均显著高于低级别胶质瘤。在两个b值下,高级别胶质瘤的平均ADC值均显著低于低级别胶质瘤。高级别和低级别胶质瘤的SI比值差异在b = 3000 s/mm²时比b = 1000 s/mm²时更大。
在3T场强下,b = 3000 s/mm²的DWI在鉴别高级别和低级别胶质瘤方面比b = 1000 s/mm²的DWI更具优势。