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目的应用扩散加权成像(DWI)探讨脑胶质瘤边缘带的ADC值变化特点,评价其对不同级别脑胶质瘤边缘带的应用价值。方法收集经手术病理切片确诊的脑胶质瘤患者40例,其中高级别(WHOⅢ-Ⅳ级)胶质瘤25例,低级别胶质瘤(WHOⅠ-Ⅱ级)15例,分别进行常规MR平扫、DWI检查及钆对比剂增强扫描。DWI梯度敏感因子b值分别取0 s/mm21、000 s/mm2,测量肿瘤实质、瘤周水肿区及水肿区周围正常脑白质区的ADC值及对侧相应正常脑白质的ADC值,并进行统计学分析。结果高级别胶质瘤实质区、瘤周水肿区及水肿周围正常脑白质区ADC值间差异无统计学意义;低级别胶质瘤肿瘤实质及水肿区ADC值差异有统计学意义(P<0.05),肿瘤实质区明显高于瘤周水肿区;高级别胶质瘤水肿周围正常脑白质区的ADC值明显高于对侧相应正常脑白质区,二者差异有统计学意义(P<0.05);低级别胶质瘤水肿周围正常脑白质区与对侧相应正常脑白质区的ADC值间差异无统计学意义。结论 MR扩散加权成像技术有助于推测胶质瘤肿瘤细胞的浸润范围,有助于手术方案的合理制定。
Objective To evaluate the value of diffusion weighted imaging (DWI) in evaluating ADC value of glioma in the marginal zone of gliomas and to evaluate its value in different grades of glioma. Methods Forty patients with gliomas confirmed by pathology were collected, including 25 cases of high grade (WHOⅢ-Ⅳ grade) gliomas and 15 cases of low grade gliomas (WHOⅠ-Ⅱ grade) Sweep, DWI examination and gadolinium contrast enhanced scan. DWI gradient-sensitive factor b values were taken 0 s / mm21,000 s / mm2, measuring the tumor parenchyma, peritumoral edema and edematous area around the normal white matter ADC value and contralateral corresponding normal white matter ADC value, and Statistical analysis. Results There was no significant difference in the ADC value between the high grade glioma in the parenchyma, the peritumoral edema area and the normal white matter area around the edema. The difference of ADC value between the low grade glioma and the edema area was statistically significant (P <0.05 ), The tumor parenchyma area was significantly higher than that in the peritumoral edema area. The ADC value of the normal white matter area around the high grade glioma edema was significantly higher than that of the corresponding normal white matter area on the contralateral side (P <0.05) There was no significant difference in ADC value between normal white matter and normal white matter in the region of low grade glioma edema. Conclusion MR diffusion weighted imaging technique is helpful to infer the extent of glioma tumor cells infiltration, which is helpful to the rational development of surgical plans.