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目的:探讨磁共振弥散加权成像(DWI)及表观扩散系数(ADC)值对不同类型成釉细胞瘤的诊断价值。方法:回顾性分析术前已行常规磁共振及DWI检查并经手术病理证实的34例成釉细胞瘤,包括原发性成釉细胞瘤26例、复发性成釉细胞瘤8例。病理类型包括单囊型6例、实体/多囊型23例、促结缔组织增生型3例、骨外/外周型2例。根据传统MR表现将所有肿瘤分为囊性12例、囊实性18例、实性4例。当b值选取0,1000s/mm2时,分别测定肿瘤实性和囊性感兴趣区(ROI)的ADC均值。采用SPSS19.0软件包进行统计学分析,比较不同类型成釉细胞瘤之间的ADC均值差异。结果:所有肿瘤实性部分ROI平均ADC值为(1.279±0.324)×10-3mm2/s,所有肿瘤囊性部分ROI平均ADC值为(2.176±0.477)×10-3mm2/s。实性部分ROI与囊性部分ROI平均ADC值差异有统计学意义(P<0.05)。囊性肿瘤与囊实性肿瘤中囊性部分ROI平均ADC值差异无统计学意义(P>0.05)。原发与复发成釉细胞瘤实性及囊性部分ROI平均ADC值差异均无统计学意义(P>0.05)。结论:ADC值的测定可作为鉴别不同类型成釉细胞瘤的辅助工具。
Objective: To investigate the diagnostic value of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) in different types of ameloblastoma. Methods: A retrospective analysis of 34 cases of ameloblastoma, including 26 cases of primary ameloblastoma and 8 cases of recurrent ameloblastoma, had been performed preoperative routine magnetic resonance and DWI examinations. Pathological types include 6 cases of single capsule, solid / multiplastic 23 cases, 3 cases of connective tissue hyperplasia, bone / peripheral 2 cases. According to the traditional MR performance, all the tumors were divided into 12 cases of cystic, solid cyst in 18 cases and solid in 4 cases. When the b values were chosen as 0,1000 s / mm2, the mean ADC values of tumor solidity and cystic area of interest (ROI) were determined. The SPSS19.0 software package was used for statistical analysis to compare ADC mean differences between different types of ameloblastoma. Results: The average ADC value of ROI in all solid tumors was (1.279 ± 0.324) × 10-3mm2 / s, and the average ADC value of ROI in all tumor cystic parts was (2.176 ± 0.477) × 10-3mm2 / s. The difference of average ADC value between ROI and cystic ROI in solid part was statistically significant (P <0.05). There was no significant difference in the mean ADC value of cystic ROI between cystic tumors and cystic solid tumors (P> 0.05). There was no significant difference in the average ADC value of ROI between primary and recurrent ameloblastoma (P> 0.05). Conclusion: The determination of ADC value can be used as a tool to identify different types of ameloblastoma.