Departments of Medical Imaging and Intervention, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou, Taiwan.
AJNR Am J Neuroradiol. 2012 May;33(5):846-51. doi: 10.3174/ajnr.A2871. Epub 2011 Dec 15.
TDLs may be indistinguishable from high-grade gliomas on conventional MR imaging. The role of DTI in differentiating TDLs from high-grade gliomas is not clear, and quantitative comparison between the 2 has not been reported. Here we aimed to differentiate TDLs from high-grade gliomas by using DTI.
DTI was performed in 8 TDLs and 13 high-grade gliomas. The presence of 3 findings (ie, intralesional hyperintensities on the FA map, restricted diffusion in the lesion periphery, and a perilesional hyperintense FA rim) was assessed by visual inspection. The FA and MD values were measured in the central nonenhancing portion, peripheral enhancing portion, and perilesional edema for each lesion and compared between the 2 groups respectively.
TDLs had a significantly higher incidence of intralesional hyperintensities on FA maps (P = .049) but a lower incidence of a perilesional hyperintense FA rim (P < .001), compared with those of high-grade gliomas on visual inspection. TDLs had significantly higher FA (P = .004) and lower MD (P = .001) values in the peripheral enhancing portions of the lesions compared with those of high-grade gliomas. In perilesional edema, FA values were significantly higher in high-grade gliomas (P = .001).
DTI is helpful in differentiating TDLs from high-grade gliomas by using visual inspection and quantitative analysis.
TDL 在常规磁共振成像上可能与高级别胶质瘤无法区分。DTI 在鉴别 TDL 和高级别胶质瘤中的作用尚不清楚,也没有关于两者的定量比较的报道。本研究旨在通过 DTI 来鉴别 TDL 和高级别胶质瘤。
对 8 例 TDL 和 13 例高级别胶质瘤患者进行 DTI 检查。通过视觉评估评估 3 种发现(即 FA 图上的病灶内高信号、病灶周围弥散受限和病灶周围高信号 FA 环)的存在。分别测量每个病灶的中央无强化部分、周围强化部分和病灶周围水肿的 FA 和 MD 值,并分别比较两组之间的 FA 和 MD 值。
与高级别胶质瘤相比,TDL 在 FA 图上病灶内高信号的发生率明显更高(P =.049),而病灶周围高信号 FA 环的发生率明显更低(P <.001)。TDL 病灶的周围强化部分的 FA 值明显更高(P =.004),MD 值明显更低(P =.001),与高级别胶质瘤相比。在病灶周围水肿中,高级别胶质瘤的 FA 值明显更高(P =.001)。
通过视觉评估和定量分析,DTI 有助于鉴别 TDL 和高级别胶质瘤。