Role of DWI and 1 H-MRS in the differential diagnosis of ring-enhancedenhanced intracranial cystic lesions
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 5
- DOI:
- 10.3760/j.issn:1005-1201.2006.05.003
- Key Word:
- 磁共振波谱学;脑脓肿;脑肿瘤
Abstract： 目的探讨MR扩散加权成像(DWI)与MR氢质子波谱(1H-MRS)技术联合应用对颅内环形强化病灶的鉴别诊断价值.方法对32例环形强化病灶行常规MRI、DWI和1H-MRS扫描.完成扫描后用Functool 2软件进行分析,获得病灶的表观扩散系数(ADC)和波谱图,并对胆碱(Cho)、N-乙酰天门冬氨酸(NAA)、肌酐(Cr)浓度进行测量.比较脓肿和肿瘤在DWI上的信号及在1H-MRS上病灶内有无氨基酸(AA)峰和病灶壁与对侧正常组织的Cho、NAA、Cho/Cr、NAA/Cr、Cho/NAA差异有无统计学意义.结果 DWI脓腔内7例(7/9)高信号,2例(2/9)混杂信号;1H-MRS脓腔内8例(8/9)有AA峰;脓肿壁Cho和NAA低于对侧,差异有统计学意义(脓肿壁和对侧正常组织的Cho分别为482.17±52.50、716.00±159.47,t=-4.398,P＜0.01;NAA分别为374.50±109.84、838.33±232.16,t=-4.718,P＜0.01),Cho/Cr、NAA/Cr、Cho/NAA与对侧差异无统计学意义(脓肿壁和对侧正常组织的Cho/Cr分别为1.83±1.16、1.20±0.34,t=1.641,P＞0.05;NAA/Cr分别为1.30±0.65、1.40±0.19,t=-0.347,P＞0.05;Cho/NAA分别为1.39±0.42、0.86±0.29,t=2.485,P＞0.05).DWI瘤腔内2例(2/23)高信号,1例(1/23)混杂信号,20例(20/23)低信号;1H-MRS瘤腔内23例均无AA峰;瘤壁Cho、Cho/Cr、Cho/NAA高于对侧,差异有统计学意义(瘤壁和对侧正常组织的Cho分别为799.57±206.09、544.93±121.58,t=6.296,P＜0.01;Cho/Cr分别为3.19±1.57、1.17±0.33,t=4.329,P＜0.01;Cho/NAA分别为4.15±2.17、0.86±0.32,t=5.494,P＜0.01),NAA、NAA/Cr低于对侧,差异有统计学意义(瘤壁和对侧正常组织的NAA分别为244.64±126.99、653.21±128.62,t=-8.525,P＜0.01,NAA/Cr分别为0.86±0.38、1.44±0.42,t=-4.624,P＜0.01).结论 DWI上绝大多数脓肿为高信号,但部分胶质瘤和转移瘤也可为高信号,此时1H-MRS可为鉴别诊断提供非常有价值的信息.
- [1]方维东,罗天友.DWI以及ADC值测量鉴别脑脓肿与坏死囊变性胶质瘤[J].2004,(4).
- [2]艾林,戴建平,高培毅,等.弥散加权图像在鉴别脑脓肿与坏死、囊变脑肿瘤中的作用[J].2001,(9).
- [3]许茂盛,潘智勇,曹志坚,等.颅脑肿瘤强化周围区域的多体素氢质子波谱研究[J].2003,(12).
- [4]B, Desprechins,T, Stadnik,G, Koerts,etc.Use of diffusion-weighted MR imaging in differential diagnosis between intracerebral necrotic tumors and cerebral abscesses.[J].1999,20.
- [5]Thauvoy C,Cosnard G,Duprez T,etc.Time dependence of serial diffusion-weighted imaging features in a case of pyogenic brain abscess.[J].2000,24(3).
- [6]Esteve F,Decorps M,Segebarth C,etc.Necrotic tumor versus brain abscess: importance of amino acids detected at 1H MR spectroscopy--initial results.[J].1999,213(3).
- [7]Kim YJ,Kim SH,Chang KH,etc.Diffusion-weighted MRI in cystic or necrotic intracranial lesions.[J].2000,42(10).
- [8]Kim HC,Song IC,Han MH,etc.Brain abscess and brain tumor: discrimination with in vivo H-1 MR spectroscopy.[J].1997,204(1).
- [9]Toyoshima S,Noguchi K,Nagayoshi T,etc.Role of diffusion-weighted echo-planar MRI in distinguishing between brain brain abscess and tumour: a preliminary report.[J].1999,41(3).
- [10]Jha DK,Prasad KN,Husain M,etc.Role of Diffusion-Weighted Imaging and In Vivo Proton Magnetic Resonance Spectroscopy in the Differential Diagnosis of Ring-Enhancing Intracranial Cystic Mass Lesions.[J].2004,28(4).
- [11]Holtas S,Burtscher IM,Geijer B,etc.A ring-enhancing metastasis with central high signal on diffusion-weighted imaging and low apparent diffusion coefficients.[J].2000,42(11).