Huang Jinbai, Luo Jing, Peng Jie, Yang Tao, Zheng Huanghua, Mao Chunping
1 Clinical Medical College of Yangtze University, Radiology Department of the First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, PR China.
2 Clinical Medical College of Yangtze University, Neurology Department of the First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, PR China.
Acta Radiol. 2017 Nov;58(11):1371-1377. doi: 10.1177/0284185116687173. Epub 2017 Jan 16.
Background Diffusion-weighted imaging (DWI) was introduced into clinical use some years ago. However, its use in the diagnosis of cerebral schistosomiasis has not been reported. Purpose To investigate the ability of the apparent diffusion coefficient (ADC) value of DWI in the diagnosis of cerebral schistosomiasis, and to differentiate it from brain high-grade gliomas and metastasis. Material and Methods Conventional brain MRI with pre-contrast, post-contrast, and DWI was performed on 50 cases of cerebral schistosomiasis, high-grade glioma, and brain metastasis. The ADC values of the three lesions, the proximal and the distal perifocal edema were measured. In order to remove the individual difference effect of ADC values, relative ADC (rADC) values were calculated through dividing the ADC value of the lesion area by that of the contralateral normal white matter. rADC values were used to evaluate the differences among cerebral schistosomiasis, brain high-grade gliomas, and metastasis. Results rADC of cerebral schistosomiasis was significantly lower than rADC of brain metastasis ( P < 0.05), without any significant differences when compared with high-grade gliomas. rADC of proximal perifocal edema in cerebral schistosomiasis was significantly higher than in high-grade gliomas ( P < 0.010), but not different compared with brain metastasis. Conclusion DWI examination with ADC values of lesions and proximal perifocal edema might be helpful in the exact diagnosis of cerebral schistosomiasis.
背景 多年前，扩散加权成像（DWI）被引入临床应用。然而，其在脑血吸虫病诊断中的应用尚未见报道。目的 探讨DWI的表观扩散系数（ADC）值在脑血吸虫病诊断中的能力，并将其与脑高级别胶质瘤和转移瘤相鉴别。材料与方法 对50例脑血吸虫病、高级别胶质瘤和脑转移瘤患者进行常规脑MRI检查，包括平扫、增强扫描及DWI。测量三种病变及其近端和远端瘤周水肿的ADC值。为消除ADC值的个体差异影响，通过将病变区域的ADC值除以对侧正常白质的ADC值计算相对ADC（rADC）值。rADC值用于评估脑血吸虫病、脑高级别胶质瘤和转移瘤之间的差异。结果 脑血吸虫病的rADC显著低于脑转移瘤（P＜0.05），与高级别胶质瘤相比无显著差异。脑血吸虫病近端瘤周水肿的rADC显著高于高级别胶质瘤（P＜0.010），但与脑转移瘤相比无差异。结论 对病变及其近端瘤周水肿进行ADC值的DWI检查可能有助于脑血吸虫病的准确诊断。
