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目的探索核磁ADC值与灌注成像相对血流量(r CBF)和相对血容量(r CBV)在鉴别原发性中枢神经系统淋巴瘤(PCNSL)与胶质母细胞瘤(GBM)的意义,提高对两种疾病的诊断准确率。方法选取2012年9月至2016年9月经本院病理证实的93例原发性中枢神经系统淋巴瘤与胶质母细胞瘤MRI平扫与动态增强数据。通过后处理软件选择动态增强图像中选择感兴趣区,测量相对血流量(r CBF)、相对血容量(r CBFV)及病灶ADC值,并对测量数据对PCNSL与GBM进行对比分析。结果 PCNSL信号均匀,弥散受限,明显强化或不均质性强化,周围可见水肿。GBM信号不均,实性部分弥散受限,多数呈不规则性强化,周围大片水肿。PCNSL的ADC值低于GBM,且差异具有统计学意义(P<0.05)。PCNSL与GBM病灶r CBF与r CBV发现,PCNSL的r CBF(2.52±0.75)和r CBV(3.57±0.93)低于GBM的r CBF(5.15±1.05)和r CBV(7.95±1.97),且差异具有统计学意义(P<0.05)。结论根据ADC值和r CBF和r CBV能够进行有效鉴别,在临床鉴别PCNSL与GBM具有重要的临床意义,能够提高PCNSL与GBM的诊断准确率。
Objective To explore the significance of rCBF and rCBV in differential diagnosis of primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM) The diagnostic accuracy of the two diseases. Methods Ninety-three patients with primary CNS and glioblastoma confirmed by pathology from September 2012 to September 2016 were selected for MRI plain and dynamic enhancement data. The region of interest (ROI), r CBF (relative blood volume), r CBFV (relative blood volume) and lesion ADC value were selected by postprocessing software in dynamic contrast-enhanced images. PCNSL and GBM were compared with measured data. Results PCNSL signal uniformity, diffusion is limited, significantly enhanced or heterogeneous enhanced around the visible edema. GBM signal is uneven, solid part of the diffusion is limited, the majority of irregular enhancement, surrounding large edema. The ADC value of PCNSL was lower than that of GBM, and the difference was statistically significant (P <0.05). PCNSL and GBM lesions r CBF and r CBV found that r CBF (2.52 ± 0.75) and r CBV (3.57 ± 0.93) were lower in PCNSL than those in GBM (5.15 ± 1.05) and r CBV (7.95 ± 1.97) Statistically significant (P <0.05). Conclusion According to ADC value and r CBF and r CBV can effectively identify PCNSL and GBM in the clinical identification of an important clinical significance, can improve the diagnostic accuracy of PCNSL and GBM.