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首页> 外文期刊>Acta Radiologica >Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema.
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Quantitative apparent diffusion coefficients in the characterization of brain tumors and associated peritumoral edema.

机译：定量表观扩散系数用于表征脑肿瘤和相关的肿瘤周围水肿。

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BACKGROUND: Conventional magnetic resonance (MR) imaging has a number of limitations in the diagnosis of the most common intracranial brain tumors, including tumor specification and the detection of tumoral infiltration in regions of peritumoral edema. PURPOSE: To prospectively assess if diffusion-weighted MR imaging (DWI) could be used to differentiate between different types of brain tumors and to distinguish between peritumoral infiltration in high-grade gliomas, lymphomas, and pure vasogenic edema in metastases and meningiomas. MATERIAL AND METHODS: MR imaging and DWI was performed on 93 patients with newly diagnosed brain tumors: 59 patients had histologically verified high-grade gliomas (37 glioblastomas multiforme, 22 anaplastic astrocytomas), 23 patients had metastatic brain tumors, five patients had primary cerebral lymphomas, and six patients had meningiomas. Apparent diffusion coefficient (ADC) values of tumor (enhancing regions or the solid portion of tumor) and peritumoral edema, and ADC ratios (ADC of tumor or peritumoral edema to ADC of contralateral white matter, ADC of tumor to ADC of peritumoral edema) were compared with the histologic diagnosis. ADC values and ratios of high-grade gliomas, primary cerebral lymphomas, metastases, and meningiomas were compared by using ANOVA and multiple comparisons. Optimal thresholds of ADC values and ADC ratios for distinguishing high-grade gliomas from metastases were determined by receiver operating characteristic (ROC) curve analysis. RESULTS: Statistically significant differences were found for minimum and mean of ADC tumor and ADC tumor ratio values between metastases and high-grade gliomas when including only one factor at a time. Including a combination of in total four parameters (mean ADC tumor, and minimum, maximum and mean ADC tumor ratio) resulted in sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of 72.9, 82.6, 91.5, and 54.3% respectively. In the ROC curve analysis, the area under the curve of the combined four parameters was the largest (0.84), indicating a good test. CONCLUSION: Our results suggest that ADC values and ADC ratios (minimum and mean of ADC tumor and ADC tumor ratio) may be helpful in the differentiation of metastases from high-grade gliomas. It cannot distinguish high-grade gliomas from lymphomas, and lymphomas from metastases. ADC values and ADC ratios in peritumoral edema cannot be used to differentiate edema with infiltration of tumor cells from vasogenic edema when measurements for high-grade gliomas, lymphomas, metastases, and meningiomas were compared.
机译：背景：常规磁共振（MR）成像在最常见的颅内脑肿瘤的诊断中有许多局限性，包括肿瘤规格和在肿瘤周围水肿区域的肿瘤浸润的检测。目的：前瞻性评估弥散加权磁共振成像（DWI）是否可用于区分不同类型的脑肿瘤，并区分高级别脑胶质瘤，淋巴瘤以及转移和脑膜瘤纯血管生成性水肿的肿瘤周围浸润。材料与方法：对93例初诊脑肿瘤的患者进行了MR成像和DWI：59例经组织学检查证实为高度脑胶质瘤（37例多形胶质母细胞瘤，22例间变性星形细胞瘤），23例转移性脑瘤，5例原发性脑瘤淋巴瘤，其中6例患有脑膜瘤。肿瘤（增强区域或肿瘤的实性部分）和肿瘤周围水肿的表观扩散系数（ADC）值和ADC比（肿瘤或肿瘤周围水肿的ADC对侧白质的ADC，肿瘤ADC对肿瘤周围水肿的ADC）为与组织学诊断相比。使用ANOVA和多重比较比较ADC值和高级神经胶质瘤，原发性脑淋巴瘤，转移瘤和脑膜瘤的比率。通过接收器工作特性（ROC）曲线分析确定用于区分高级别胶质瘤和转移的ADC值和ADC比率的最佳阈值。结果：当一次仅包含一个因素时，转移和高级别神经胶质瘤之间ADC肿瘤的最小值和平均值以及ADC肿瘤比率值存在统计学差异。包括总共四个参数（平均ADC肿瘤以及最小，最大和平均ADC肿瘤比率）的组合，其敏感性，特异性，阳性（PPV）和阴性预测值（NPV）分别为72.9、82.6、91.5和54.3 ％ 分别。在ROC曲线分析中，组合的四个参数的曲线下面积最大（0.84），表明测试良好。结论：我们的结果表明ADC值和ADC比率（ADC肿瘤的最小和均值以及ADC肿瘤比率）可能有助于区分高级别胶质瘤的转移。它不能区分高级神经胶质瘤和淋巴瘤，还是淋巴瘤和转移瘤。比较高级别神经胶质瘤，淋巴瘤，转移瘤和脑膜瘤的测量值时，不能使用肿瘤周围水肿中的ADC值和ADC比值来区分肿瘤细胞浸润和血管源性水肿。

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