Wen Yang, Peng Yun, Duan Xiao Min, Zhang Nan
Department of Radiology, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Department of Pathology, Beijing Children's Hospital, Capital Medical University, Beijing, China.
J Med Imaging Radiat Oncol. 2017 Dec;61(6):718-724. doi: 10.1111/1754-9485.12615. Epub 2017 May 16.
Diffusion-weighted MR imaging (DWI) has demonstrated a great potential to help distinguish benign from malignant tumours in paediatric body. Our purpose is to evaluate whether DWI allow discrimination of thoracoabdominal neuroblastic tumours of various histological types and differentiation grades.
We retrospectively analysed DWI scans of the thoracoabdominal neuroblastic tumours in 25 children (11 girls, 14 boys). DWI was performed with two b-values of 0 and 800 s/mm on a 3.0T MR scanner. The apparent diffusion coefficient (ADC) values of different classifications of tumours were compared with Independent-Samples T Test.
In the 25 cases, ganglioneuroma (GN) was in 3 cases, ganglioneuroblastoma (GNB) in 7 (GNB-Intermixed in 4, GNB-Nodular in 3) and neuroblastoma (NB) in 15. In three cases of GNB-Nodular, two cases had poorly differentiated nodules and another had differentiated nodules. In 15 cases of NB, poorly differentiated, differentiated and undifferentiated tumours were, respectively, in eight, five and two cases. The ADC value of the NB was significantly lower than that of GN/GNB (P < 0.001). The ADC of GNB-Nodular/NB was significantly less than that of GN/GNB-Intermixed (P < 0.0001). In GNB-Nodular/NB detection, there was a cut-off value of 1.165 × 10 mm /s. In GNB-Nodular/NB, the tumours with poorly differentiated and undifferentiated lesions (n = 12) had significantly smaller ADC than those with differentiated composition (n = 6) (P = 0.0012).
ADC of DWI is highly valuable for discriminating thoracoabdominal neuroblastic tumours of different histological types and differentiation grades.
扩散加权磁共振成像（DWI）已显示出在帮助鉴别儿科身体部位良性与恶性肿瘤方面具有巨大潜力。我们的目的是评估DWI是否能够区分不同组织学类型和分化程度的胸腹部神经母细胞瘤。
我们回顾性分析了25例儿童（11例女孩，14例男孩）胸腹部神经母细胞瘤的DWI扫描图像。在3.0T磁共振扫描仪上采用b值为0和800 s/mm²的两个参数进行DWI检查。采用独立样本t检验比较不同分类肿瘤的表观扩散系数（ADC）值。
25例病例中，神经节瘤（GN）3例，神经节神经母细胞瘤（GNB）7例（其中混合型4例，结节型3例），神经母细胞瘤（NB）15例。在3例结节型GNB中，2例为低分化结节，1例为分化结节。15例NB中，低分化、分化和未分化肿瘤分别为8例、5例和2例。NB的ADC值显著低于GN/GNB（P<0.001）。结节型GNB/NB的ADC显著低于混合型GN/GNB（P<0.0001）。在结节型GNB/NB检测中，有一个1.165×10⁻³mm²/s的临界值。在结节型GNB/NB中，具有低分化和未分化病变的肿瘤（n = 12）的ADC显著小于具有分化成分的肿瘤（n = 6）（P = 0.0012）。
DWI的ADC值在鉴别不同组织学类型和分化程度的胸腹部神经母细胞瘤方面具有很高的价值。
