Kinoshita Yasuyuki, Yamasaki Fumiyuki, Tominaga Atsushi, Ohtaki Megu, Usui Satoshi, Arita Kazunori, Sugiyama Kazuhiko, Kurisu Kaoru
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of Environmetrics and Biometrics, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Neurosurg Rev. 2016 Apr;39(2):207-13; discussion 213. doi: 10.1007/s10143-015-0660-0. Epub 2015 Aug 18.
The apparent diffusion coefficient (ADC) on diffusion-weighted imaging (DWI) plays an important role in diagnosing intracranial tumors and predicting the histopathological grade of the tumor. However, the differences in the ADC values between craniopharyngiomas and germ cell tumors (GCTs) have not been clarified. We therefore evaluated the DWI and ADC values at b = 1000 and b = 4000 s/mm(2) on 3T magnetic resonance (MR) imaging and assessed the possibility of differentiating between craniopharyngiomas and GCTs. We retrospectively reviewed 19 patients with craniopharyngioma and 24 patients with GCT who underwent surgery and received a histopathological diagnosis. Thirty-four patients underwent DWI with b = 1000 and b = 4000 s/mm(2) and nine patients underwent periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) DWI with b = 1000 s/mm(2). The ADC was determined by manually placing regions of interests (ROIs) in the respective tumor regions on the ADC maps and is expressed as the minimum (ADC(MIN)), mean (ADC(MEAN)), and maximum (ADC(MAX)) absolute values. The craniopharyngiomas showed lower intensity on DWI at b = 1000 and b = 4000 s/mm(2) than the GCTs. Furthermore, the craniopharyngiomas demonstrated significantly high ADC values (ADC(MIN), ADC(MEAN), and ADC(MAX)) in comparison with the GCTs on DWI at b = 1000 and b = 4000 s/mm(2). The logistic discriminant analysis clarified the advantage of ADC(MIN) at b = 4000 s/mm(2) in differentiating between craniopharyngiomas and GCTs compared with the other ADC values. DWI and the ADC values may help clinicians to differentiate between craniopharyngiomas and GCTs. The ADC(MIN) at b = 4000 s/mm(2) is particularly useful for differentiation.
扩散加权成像（DWI）中的表观扩散系数（ADC）在颅内肿瘤的诊断及肿瘤组织病理学分级预测中发挥着重要作用。然而，颅咽管瘤与生殖细胞瘤（GCTs）之间ADC值的差异尚未明确。因此，我们评估了在3T磁共振（MR）成像上b = 1000和b = 4000 s/mm²时的DWI及ADC值，并评估了鉴别颅咽管瘤与GCTs的可能性。我们回顾性分析了19例接受手术并获得组织病理学诊断的颅咽管瘤患者和24例GCTs患者。34例患者接受了b = 1000和b = 4000 s/mm²的DWI检查，9例患者接受了b = 1000 s/mm²的周期性旋转重叠平行线增强重建（PROPELLER）DWI检查。通过在ADC图上的各个肿瘤区域手动放置感兴趣区（ROIs）来确定ADC值，并将其表示为最小（ADC(MIN)）、平均（ADC(MEAN)）和最大（ADC(MAX)）绝对值。颅咽管瘤在b = 1000和b = 4000 s/mm²的DWI上显示出比GCTs更低的信号强度。此外，与GCTs相比，颅咽管瘤在b = 1000和b = 4000 s/mm²的DWI上表现出显著更高的ADC值（ADC(MIN)、ADC(MEAN)和ADC(MAX)）。逻辑判别分析表明，与其他ADC值相比，b = 4000 s/mm²时的ADC(MIN)在鉴别颅咽管瘤与GCTs方面具有优势。DWI及ADC值可能有助于临床医生鉴别颅咽管瘤与GCTs。b = 4000 s/mm²时的ADC(MIN)在鉴别诊断中尤为有用。
