原发性脑淋巴瘤与多形性胶质母细胞瘤：通过扩散张量成像评估的扩散特征差异
Primary cerebral lymphoma and glioblastoma multiforme: differences in diffusion characteristics evaluated with diffusion tensor imaging.
作者信息
Toh C-H, Castillo M, Wong A M-C, Wei K-C, Wong H-F, Ng S-H, Wan Y-L
机构信息
Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
出版信息
AJNR Am J Neuroradiol. 2008 Mar;29(3):471-5. doi: 10.3174/ajnr.A0872. Epub 2007 Dec 7.
BACKGROUND AND PURPOSE
Differentiating between primary cerebral lymphoma and glioblastoma multiforme (GBM) based on conventional MR imaging sequences may be impossible. Our hypothesis was that there are significant differences in fractional anisotropy (FA) and apparent diffusion coefficient (ADC) between lymphoma and GBM, which will allow for differentiation between them.
MATERIALS AND METHODS
Preoperative diffusion tensor imaging (DTI) was performed in 10 patients with lymphoma and 10 patients with GBM. Regions of interest were placed in only solid-enhancing tumor areas and the contralateral normal-appearing white matter (NAWM) to measure the FA and ADC values. The differences in FA and ADC between lymphoma and GBM, as well as between solid-enhancing areas of each tumor type and contralateral NAWM, were analyzed statistically. Cutoff values of FA, FA ratio, ADC, and ADC ratio for distinguishing lymphomas from GBMs were determined by receiver operating characteristic curve analysis.
RESULTS
FA and ADC values of lymphoma were significantly decreased compared with NAWM. Mean FA, FA ratio, ADC (x10(-3) mm(2)/s), and ADC ratios were 0.140 +/- 0.024, 0.25 +/- 0.04, 0.630 +/- 0.155, and 0.83 +/- 0.14 for lymphoma, respectively, and 0.229 +/- 0.069, 0.40 +/- 0.12, 0.963 +/- 0.119, and 1.26 +/- 0.13 for GBM, respectively. All of the values were significantly different between lymphomas and GBM. Cutoff values to differentiate lymphomas from GBM were 0.192 for FA, 0.33 for FA ratio, 0.818 for ADC, and 1.06 for ADC ratio.
CONCLUSIONS
The FA and ADC of primary cerebral lymphoma were significantly lower than those of GBM. DTI is able to differentiate lymphomas from GBM.
背景与目的
基于传统磁共振成像序列区分原发性脑淋巴瘤和多形性胶质母细胞瘤（GBM）可能是不可能的。我们的假设是淋巴瘤和GBM之间的分数各向异性（FA）和表观扩散系数（ADC）存在显著差异，这将有助于区分它们。
材料与方法
对10例淋巴瘤患者和10例GBM患者进行术前扩散张量成像（DTI）。感兴趣区仅置于肿瘤实性强化区域及对侧正常白质（NAWM），以测量FA和ADC值。对淋巴瘤和GBM之间以及每种肿瘤类型的实性强化区域与对侧NAWM之间的FA和ADC差异进行统计学分析。通过受试者工作特征曲线分析确定区分淋巴瘤和GBM的FA、FA比值、ADC和ADC比值的截断值。
结果
与NAWM相比，淋巴瘤的FA和ADC值显著降低。淋巴瘤的平均FA、FA比值、ADC（×10⁻³mm²/s）和ADC比值分别为0.140±0.024、0.25±0.04、0.630±0.155和0.83±0.14，GBM的分别为0.229±0.069、0.40±0.12、0.963±0.119和1.26±0.13。淋巴瘤和GBM之间所有这些值均有显著差异。区分淋巴瘤和GBM的截断值为：FA为0.192，FA比值为0.33，ADC为0.818，ADC比值为1.06。
结论
原发性脑淋巴瘤的FA和ADC显著低于GBM。DTI能够区分淋巴瘤和GBM。
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