DWI联合ADC在原发性中枢神经系统淋巴瘤与急性脑梗死鉴别诊断中的价值-现代医学

DWI联合ADC在原发性中枢神经系统淋巴瘤与急性脑梗死鉴别诊断中的价值

单位：湖北医药学院附属东风医院影像科, 湖北十堰 442008

分类号：R445.2

出版年·卷·期（页码）：2018·46·第一期（23-26）

摘要：

目的：探讨在鉴别原发性中枢神经系统淋巴瘤（PCNSL）与急性脑梗死的过程中弥散加权成像（DWI）联合表观弥散系数（ADC）的诊断价值。方法：采用回顾性研究方法，以2013年2月至2017年2月于我院就诊的80例急性脑梗死患者（急性脑梗死组）及20例PCNSL患者（PCNSL组）为研究对象。所有患者行DWI联合ADC检查，记录DWI信号强度，ADC、负性增强积分（NEI）、平均增强时间（MTE）值，并判断两者联合在PCNSL与急性脑梗死鉴别诊断中的价值。结果：在DWI b值为400、600与1 000 s·mm^-2的条件下，DWI信号强度PCNSL组均低于急性脑梗死组（P<0.05）；ADC、NEI值PCNSL组也明显小于急性脑梗死组（均P<0.05）；两组MTE值比较，差异无统计学意义（P>0.05）。取DWI b值为1 000 s·mm^-2时，选取ADC为0.83×10^-3 mm²·s^-1作为诊断阈值，DWI联合ADC在PCNSL与急性脑梗死鉴别诊断中的敏感度和特异度均较高，分别为96.2%和94.4%。结论：DWI联合ADC在PCNSL与急性脑梗死鉴别诊断中有很好的价值，能通过信号强度与扩散系数反映病情，从而有利于两者的鉴别诊断。

Objective:To investigate the differential diagnostic values of diffusion weighted imaging (DWI) combined with apparent diffusion coefficient (ADC) in primary central nervous system lymphoma(PCNSL) and acute cerebral infarction. Methods:The retrospective analysis method was performed, the 80 patients with acute cerebral infarction (acute cerebral infarction group) and 20 patients with PCNSL (PCNSL group)in our hospital from February 2013 to February 2017 were selected as the research objects. All patients were detected with DWI combined with ADC,DWI signal strength and ADC,NEI,MET value were recorded. Results:When the DWI b value were 400, 600 and 1 000 s·mm^-2,the signal intensity of DWI inPCNSL group were lower than those of acute cerebral infarction group(P<0.05);ADC and NEI value in PCNSL group were significantly lower than those of acute cerebral infarction group (all P<0.05). MTE value had no significant difference between the two groups(P>0.05).When DWI b value was 1 000 s·mm^-2 andADC was 0.83×10^-3 mm²·s^-1 as the diagnostic threshold, the sensitivity and specificity of DWI combined with ADCin differential diagnosis of PCNSL and acute cerebral infarction were 96.2% and 94.4%,respectively. Conclusion:DWI combined with ADC in the identification of PCNSL and acute cerebral infarction has a good value, it reflects the disease through the signal intensity and diffusion coefficient, which is conducive to the differential diagnosis.

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