Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
AJNR Am J Neuroradiol. 2013 Apr;34(4):802-7. doi: 10.3174/ajnr.A3316. Epub 2012 Nov 1.
A number of benign and malignant peripheral nerve tumor and tumorlike conditions produce similar imaging features on conventional anatomic MR imaging. Functional MR imaging using DTI can increment the diagnostic performance in differentiation of these lesions. Our aim was to evaluate the role of 3T anatomic MR imaging and DTI in the characterization of peripheral nerve tumor and tumorlike conditions.
Twenty-nine patients (13 men, 16 women; mean age, 41±18 years; range, 11-83 years) with a nerve tumor or tumorlike condition (25 benign, 5 malignant) underwent 3T MR imaging by using anatomic (n=29), functional diffusion, DWI (n=21), and DTI (n=24) techniques. Images were evaluated for image quality (3-point scale), ADC of the lesion, tractography, and fractional anisotropy of nerves with interobserver reliability in ADC and FA measurements.
No significant differences were observed in age (benign, 40±18 versus malignant, 45±19 years) and sex (benign, male/female=12:12 versus malignant, male/female=3:2) (P>.05). All anatomic (29/29, 100%) MR imaging studies received "good" quality; 20/21 (95%) DWI and 21/24 (79%) DTI studies received "good" quality. ADC of benign lesions (1.848±0.40×10(-3) mm2/s) differed from that of malignant lesions (0.900±0.25×10(-3) mm2/s, P<.001) with excellent interobserver reliability (ICC=0.988 [95% CI, 0.976-0.994]). There were no FA or ADC differences between men and women (P>.05). FA of involved nerves was lower than that in contralateral healthy nerves (P<.001) with excellent interobserver reliability (ICC=0.970 [95% CI, 0.946-0.991]). ADC on DTI and DWI was not statistically different (P>.05), with excellent intermethod reliability (ICC=0.943 [95% CI, 0.836-0.980]). Tractography differences were observed in benign and malignant lesions.
3T MR imaging and DTI are valuable methods for anatomic and functional evaluation of peripheral nerve lesions with excellent interobserver reliability. While tractography and low FA provide insight into neural integrity, low diffusivity values indicate malignancy in neural masses.
许多良性和恶性周围神经肿瘤和肿瘤样病变在常规解剖磁共振成像上产生相似的影像学特征。使用 DTI 的功能磁共振成像可以提高这些病变的诊断性能。我们的目的是评估 3T 解剖磁共振成像和 DTI 在周围神经肿瘤和肿瘤样病变特征中的作用。
29 例患者（男 13 例，女 16 例；平均年龄 41±18 岁；范围 11-83 岁）患有神经肿瘤或肿瘤样病变（良性 25 例，恶性 5 例），接受了 3T 磁共振成像检查，包括解剖学成像（n=29）、功能扩散成像、DWI（n=21）和 DTI（n=24）技术。通过观察者间可靠性评估图像质量（3 分制）、病变 ADC 值、示踪图和神经各向异性分数。
年龄（良性，40±18 岁与恶性，45±19 岁）和性别（良性，男/女=12:12 与恶性，男/女=3:2）无显著差异（P＞0.05）。所有解剖学（29/29，100%）磁共振成像研究均获得“良好”质量；20/21（95%）DWI 和 21/24（79%）DTI 研究均获得“良好”质量。良性病变的 ADC 值（1.848±0.40×10(-3)mm2/s）与恶性病变（0.900±0.25×10(-3)mm2/s，P＜0.001）不同，观察者间可靠性良好（ICC=0.988[95%CI，0.976-0.994]）。男性和女性之间的 FA 或 ADC 值无差异（P＞0.05）。受累神经的 FA 值低于对侧健康神经（P＜0.001），观察者间可靠性良好（ICC=0.970[95%CI，0.946-0.991]）。DTI 和 DWI 的 ADC 值无统计学差异（P＞0.05），两种方法之间的可靠性良好（ICC=0.943[95%CI，0.836-0.980]）。良性和恶性病变之间观察到示踪图差异。
3T 磁共振成像和 DTI 是评估周围神经病变的有价值的解剖学和功能评估方法，具有良好的观察者间可靠性。虽然示踪图和低 FA 提供了对神经完整性的了解，但低扩散值提示神经肿块的恶性程度。
