Differential Diagnostic Value of Magnetic Resonance Diffusion-weighted Imaging in Cerebellar Parenchymal Hemangioblastoma
Objective To investigate the value of magnetic resonance diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)in the differential diagnosis of cerebellar parenchymal hemangioblastoma.Methods In this study,a retrospective comparative analysis of MRI imaging data of 24 patients with surgically and pathologically confirmed cerebellar parenchymal hemangioblastoma(HB)and 45 patients with other types of cerebellar parenchymal tumour with rich blood supply was performed.In this study,the mean apparent diffusion coefficient(ADC)values of the tumour parenchymal region and the contralateral normal cerebellar region were determined,from which the standardised ADC value,i.e.,the ratio of the ADC value of the tumour parenchymal region to the ADC value of the normal cerebellar region,was calculated.The independent samples t-test was used to compare the mean ADC values with the standardised ADC values of the two groups of cases.In addition,we evaluated and compared the diagnostic efficacy of the mean ADC values,the standardised ADC values,and the combination of the two using subject work characteristic curve(ROC)analysis.Results MRI analysis of 24 cases of cerebellar parenchymal hemangioblastoma(HB)showed that 19 cases showed low signal on diffusion-weighted imaging(DWI),5 cases were isosignal,and either isosignal or high signal on apparent diffusion coefficient(ADC)maps,with an average ADC value of(1.99±0.41)×10-3mm2/s and a standardised ADC of 2.86±0.63.For 45 cases of other types of cerebellar parenchymal blood-rich tumours,DWI showed that 41 cases showed high signal characteristics,3 cases were isosignal,and 1 case was low signal.For the 45 other types of cerebellar parenchymal blood-rich tumours,DWI showed that 41 tumours showed high signal,3 showed iso-signal,and 1 showed low signal,with an average apparent diffusion coefficient(ADC)value of(0.86±0.17)×10-3mm2/s and a normalised ADC value of 1.25±0.31.Comparing the two groups of data,the ADC and standardised ADC values of cerebellar parenchymal hemangioblastoma were significantly higher than those of other blood-rich tumours,and this difference was statistically significant(t=16.144,P＜0.001;t=14.266,P＜0.001).When a standardised ADC value of 2.95 was set as the threshold for diagnosing cerebellar parenchymal hemangioblastoma,the diagnostic sensitivity was 76.12％,the specificity was 92.45％,and the area under the subject's operating characteristic curve(ROC)was 0.805.The diagnostic sensitivity and specificity were the highest when applying ADC values in conjunction with the standardised ADC value,with 82.25％and 88.69％,and the area under the ROC curve increased to 0.867.Conclusion ADC values and their standardisation are valuable in differentiating cerebellar parenchymal hemangioblastoma(HB)from other cerebellar parenchymal blood-rich tumours.The combination of ADC values and standardised ADC values is a high-performance MRI parameter for the diagnosis of cerebellar HB.
万方数据
维普
