Krabbe K, Gideon P, Wagn P, Hansen U, Thomsen C, Madsen F
Danish Research Center of Magnetic Resonance, Hvidovre Hospital, Denmark.
Neuroradiology. 1997 Jul;39(7):483-9. doi: 10.1007/s002340050450.
We used MRI for in vivo measurement of brain water self-diffusion in patients with intracranial tumours. The study included 28 patients (12 with high-grade and 3 with low-grade gliomas, 7 with metastases, 5 with meningiomas and 1 with a cerebral abscess). Apparent diffusion coefficients (ADC) were calculated in a single axial slice through the tumours, the sequence was sensitive to diffusion along the cephalocaudal axis. Our main finding was that ADC in contrast-enhancing areas within cerebral metastases was statistically significantly higher than ADC in contrast-enhancing areas in high-grade gliomas (P < or = 0.05). Furthermore, the ADC in oedema surrounding metastases were statistically significantly higher the ADC in oedema around high-grade gliomas (P < or = 0.02). The ADC in patients with meningiomas did not differ significantly from those seen with high-grade gliomas or cerebral metastases. The highest ADC were found within cystic or necrotic tumour areas. In one patient with a cerebral abscess, suspected of having a high-grade glioma, the ADC was similar to that in high-grade gliomas. The finding of higher ADC in cerebral metastases than in high-grade gliomas may be helpful in trying to distinguish between these tumours preoperatively; it suggests increased free extracellular and/or intracellular water fraction in cerebral metastases. The method seems to hold potential for further noninvasive characterisation of intracranial tumours.
我们使用磁共振成像(MRI)对颅内肿瘤患者的脑水自扩散进行活体测量。该研究纳入了28例患者(12例高级别胶质瘤、3例低级别胶质瘤、7例转移瘤、5例脑膜瘤和1例脑脓肿)。在穿过肿瘤的单个轴位切片上计算表观扩散系数(ADC),该序列对沿头尾轴的扩散敏感。我们的主要发现是,脑转移瘤中强化区域的ADC在统计学上显著高于高级别胶质瘤强化区域的ADC(P≤0.05)。此外,转移瘤周围水肿中的ADC在统计学上显著高于高级别胶质瘤周围水肿中的ADC(P≤0.02)。脑膜瘤患者的ADC与高级别胶质瘤或脑转移瘤患者的ADC无显著差异。最高的ADC出现在囊性或坏死性肿瘤区域。在1例疑似高级别胶质瘤的脑脓肿患者中,ADC与高级别胶质瘤中的相似。脑转移瘤中ADC高于高级别胶质瘤这一发现可能有助于术前区分这些肿瘤;这表明脑转移瘤中细胞外和/或细胞内自由水分数增加。该方法似乎具有对颅内肿瘤进行进一步无创特征描述的潜力。