计算扩散加权成像对脑肿瘤显示能力的评估

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摘要目的：探讨计算扩散加权成像（cDWI）对脑肿瘤的显示能力。方法：收集温州医科大学附属第一医院2016年3月至2017年10月间经手术切除后有病理结果，并且在术前1个月内行颅脑多模态磁共振扫描的脑肿瘤患者共24例，男15例，女9例，年龄13～73岁，平均（49±15）岁。根据扫描所得DWI图像单指数模型拟合重建系列b值（b=1 500、2 000、2 500、3 000、3 500、4 000 s/mm2）cDWI图像，分别测量肿瘤、灶周水肿及正常脑白质信号强度St、Se及Sn，定量比较各b值cDWI和扫描所得mDWI 1 000图像肿瘤与正常脑白质间对比度（CRn）及肿瘤与瘤周水肿间对比度（CRe）。结果：标准化后CRe 2 500、CRe 3 000、CRe 3 500、CRe 4 000显著高于mCRe 1 000（均P＜0.05）。结论：对于存在瘤周水肿的脑肿瘤，高b值cDWI图像能增强其与瘤周水肿间的对比，并具有检出恶性肿瘤灶周浸润的潜在能力。

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	陈中伟
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关键词 ：脑肿瘤, 磁共振成像, 计算扩散加权成像

Abstract：Objective: To assess the ability of computed diffusion-weighted imaging (cDWI) to improve the conspicuousness of brain tumors. Methods: Twenty-four patients with brain tumors (15 male and 9 female, ranging from 13 to 73 in age) who had undergone multi-parameters MRI examinations at 3.0T followed by surgery with the interval less than one month were included in this study. 2 b values DWI was used to synthesize images acquired by computed diffusion weighted imaging (cDWI) at b values of 1 500, 2 000, 2 500, 3 000, 3 500, 4 000 s/mm2. Regions of interest (ROIs) were placed on tumor lesions, peritumoral edema regions and normal-appearing white matter regions, respectively. The signal intensity of ROIs were measured and compared. The contrast ratio (CR) between tumor lesions and normal-appearing white matter regions (CRn) and that between tumor lesions and peritumoral edema regions (CRe) in cDWI images were both compared with measured DWI images. Results: The standardized contrast ratios between tumor and peritumoral edema in cDWI images at b values of 2 500, 3 000, 3 500 and 4 000 s/mm2 were significantly higher than that in measured DWI images at b values of 1 000 s/mm2 (mDWI 1 000) (P<0.05). Conclusion: The high b-value cDWI images could enhance the contrast between brain tumor and the peritumoral edema regions, which has showed potential for the detection of peritumoral invasion of malignant tumor.

Key words： brain tumor magnetic resonance imaging computed diffusion weighted imaging

收稿日期: 2018-05-03

基金资助:温州市公益性社会发展（医疗卫生）科技项目（Y2016 0156）。

作者简介: 陈中伟（1990-），男，浙江温州人，住院医师。

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https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I10/769

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