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目的探讨MRI弥散加权成像对胶质瘤病理分级的诊断价值。方法对经手术病理证实的27例胶质瘤患者进行常规MRI序列扫描和DWI检查,对照分析病变的实质部分、周围水肿区以及正常脑组织的ADC值、eADC值。结果12例Ⅲ、Ⅳ级胶质瘤中,6例肿瘤实质部分于DWI表现为高信号,4例为等信号,2例为低或稍低信号。15例Ⅰ、Ⅱ级胶质瘤中,3例肿瘤实质部分于DWI表现为高信号,5例为等信号,7例为低或稍低信号。胶质瘤的ADC值和eADC值均与正常的脑组织差异有统计学意义(P<0.05);Ⅲ、Ⅳ级胶质瘤实质部分的ADC值和eADC值分别较Ⅰ~Ⅱ级胶质瘤瘤体低和高(P<0.05);其瘤周水肿区的ADC值(eADC值)明显低于(高于)Ⅰ~Ⅱ级胶质瘤(P<0.05)。结论ADC值(eADC值)结合常规MRI序列的特征,对于胶质瘤的分级诊断具有临床应用价值。
Objective To investigate the diagnostic value of MRI diffusion-weighted imaging in pathological grading of glioma. Methods Twenty-seven patients with glioma confirmed by surgery and pathology were examined by conventional MRI and DWI. The ADC value and eADC value of the edema and surrounding edema area were compared between the two groups. Results Of the 12 cases with grade Ⅲ and Ⅳ gliomas, the tumor parenchyma of 6 cases showed high signal in DWI, 4 cases of equal signal and 2 cases of low or slightly low signal. Of the 15 grade I and grade II gliomas, three of the three tumors showed high signal intensity on DWI, five were equal signal, and seven were low or slightly lower signal. The ADC values and eADC values of gliomas were significantly different from those of normal brain tissues (P <0.05). The ADC values and eADC values of grade III and IV gliomas were significantly higher than those of grade I-II gliomas The ADC value (eADC value) in the peritumoral edema area was significantly lower than (higher than) grade Ⅰ ~ Ⅱ glioma (P <0.05). Conclusion The ADC value (eADC value) combined with the characteristics of conventional MRI sequences has clinical value for the grading diagnosis of glioma.