Caravan Ionut, Ciortea Cristiana Augusta, Contis Alexandra, Lebovici Andrei
1 37576 "Iuliu Hatieganu" University of Medicine and Pharmacy , Cluj-Napoca, Romania.
2 Department of Radiology, Emergency County Hospital, Cluj-Napoca, Romania.
Acta Radiol. 2018 May;59(5):599-605. doi: 10.1177/0284185117727787. Epub 2017 Aug 23.
Background High-grade gliomas (HGGs) and brain metastases (BMs) can display similar imaging characteristics on conventional MRI. In HGGs, the peritumoral edema may be infiltrated by the malignant cells, which was not observed in BMs. Purpose To determine whether the apparent diffusion coefficient values could differentiate HGGs from BMs. Material and Methods Fifty-seven patients underwent conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) before treatment. The minimum and mean ADC in the enhancing tumor (ADC, ADC) and the minimum ADC in the peritumoral region (ADC) were measured from ADC maps. To determine whether there was a statistical difference between groups, ADC values were compared. A receiver operating characteristic (ROC) curve analysis was used to determine the cutoff ADC value for distinguishing between HGGs and BMs. Results The mean ADC values in the intratumoral regions of HGGs were significantly higher than those in BMs. No differences were observed between groups regarding ADC values. The mean ADC values in the peritumoral edema of HGGs were significantly lower than those in BMs. According to ROC curve analysis, a cutoff value of 1.332 × 10mm/s for the ADC generated the best combination of sensitivity (95%) and specificity (84%) for distinguishing between HGGs and BMs. The same value showed a sensitivity of 95.6% and a specificity of 100% for distinguishing between GBMs and BMs. Conclusion ADC values from DWI were found to distinguish between HGGs and solitary BMs. The peritumoral ADC values are better than the intratumoral ADC values in predicting the tumor type.
背景 高级别胶质瘤（HGGs）和脑转移瘤（BMs）在传统磁共振成像（MRI）上可表现出相似的影像学特征。在HGGs中，瘤周水肿可能被恶性细胞浸润，而在BMs中未观察到这种情况。目的 确定表观扩散系数值是否能区分HGGs和BMs。材料与方法 57例患者在治疗前接受了传统磁共振成像（MRI）和扩散加权成像（DWI）检查。从表观扩散系数图测量增强肿瘤内的最小表观扩散系数值和平均表观扩散系数值（ADC、ADC）以及瘤周区域的最小表观扩散系数值（ADC）。为确定组间是否存在统计学差异，对表观扩散系数值进行了比较。采用受试者操作特征（ROC）曲线分析来确定区分HGGs和BMs的表观扩散系数临界值。结果 HGGs肿瘤内区域的平均表观扩散系数值显著高于BMs。在表观扩散系数值方面，组间未观察到差异。HGGs瘤周水肿的平均表观扩散系数值显著低于BMs。根据ROC曲线分析，表观扩散系数的临界值为1.332×10⁻³mm²/s时，在区分HGGs和BMs方面产生了最佳的敏感性（95%）和特异性（84%）组合。相同的值在区分胶质母细胞瘤（GBMs）和BMs方面显示出95.6%的敏感性和100%的特异性。结论 发现扩散加权成像的表观扩散系数值可区分HGGs和孤立性BMs。在预测肿瘤类型方面，瘤周表观扩散系数值优于肿瘤内表观扩散系数值。
