Hao Mei Zheng, Zheng Long Meng, Ma Xing Xin, Hu Hong Chun, Xing Ming Jian, Zhu Fei Hong
Department of Radiology,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215006,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2019 Dec 30;41(6):756-760. doi: 10.3881/j.issn.1000-503X.11188.
To investigate the value of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)in the diagnosis and differential diagnosis of posterior fossa solid hemangioblastoma(PFSH). We retrospectively analyzed the clinical data of 15 PFSH patients and 58 patients with other hypervascular tumors in the posterior fossa(the latter included 23 cases of meningioma,5 cases of medulloblastoma,8 cases of acoustic neuroma,4 cases of hemangiopericytoma,5 cases of lymphoma,9 cases of metastatic tumor,3 cases of astrocytoma,and 1 case of choroid plexus papilloma)confirmed by operation and pathology.All patients underwent axial DWI scans,and the mean ADC value of solid part of the tumors and the adjacent normal cerebellar white matter were measured,and then the normalized ADC was calculated.In addition, test was used to compare the differences in mean ADC and normalized ADC between these two groups,and receiver operating characteristic(ROC)curve was applied to analyze the diagnostic performance of normalized ADC. Of all the 15 PFSH patients,DWI appeared hypointense in 12 patients and isointense in 3 patients;the signals on ADC maps were isointense or hyperintense;the mean ADC value of PFSHs was(1.881±0.445)×10 mm /s and the normalized ADC was 2.70±0.62.In contrast,in 58 patients with other tumors in the posterior fossa,DWI appeared hyperintense in 51 cases,isointense in 3 cases,and hypointense in 4 cases;the mean ADC value was(0.771±0.202)×10 mm /s,and the normalized ADC was 1.17±0.33.Thus,the ADC value and normalized ADC value were significantly higher in PFSH than in other tumors in the posterior fossa(=9.419,<0.001;=9.184,<0.001).The cut-off value of the normalized ADC for the diagnosis of solid hemangioblastoma was 1.89,with the sensitivity and specificity being 100%and 96.6%respectively,and the area under the ROC curve was 0.989. ADC and normalized ADC are valuable in the differential diagnosis of PFSH from other tumors with abundant blood supply.
探讨扩散加权成像(DWI)及表观扩散系数(ADC)在小脑后窝实性血管母细胞瘤(PFSH)诊断及鉴别诊断中的价值。回顾性分析15例PFSH患者及58例小脑后窝其他富血管肿瘤患者(后者包括23例脑膜瘤、5例髓母细胞瘤、8例听神经瘤、4例血管外皮细胞瘤、5例淋巴瘤、9例转移瘤、3例星形细胞瘤及1例脉络丛乳头状瘤)的临床资料,所有患者均行轴位DWI扫描,测量肿瘤实性部分及相邻正常小脑白质的平均ADC值,计算标准化ADC值。此外,采用检验比较两组间平均ADC及标准化ADC的差异,并应用受试者工作特征(ROC)曲线分析标准化ADC的诊断效能。15例PFSH患者中,12例DWI呈低信号,3例呈等信号;ADC图上信号呈等信号或高信号;PFSH的平均ADC值为(1.881±0.445)×10⁻³mm²/s,标准化ADC为2.70±0.62。相比之下,58例小脑后窝其他肿瘤患者中,51例DWI呈高信号,3例呈等信号,4例呈低信号;平均ADC值为(0.771±0.202)×10⁻³mm²/s,标准化ADC为1.17±0.33。因此,PFSH的ADC值及标准化ADC值显著高于小脑后窝其他肿瘤(t=9.419,P<0.001;t=9.184,P<0.001)。标准化ADC诊断实性血管母细胞瘤的截断值为1.89,敏感度和特异度分别为100%和96.6%,ROC曲线下面积为0.989。ADC及标准化ADC在PFSH与其他血供丰富肿瘤的鉴别诊断中有重要价值。