罗海营,黄飚,刘红军,张水兴,王广谊,梁长虹.MR边界征及皮质征用于鉴别脑单发转移瘤与高级别星形细胞肿瘤[J].中国医学影像技术,2010,26(2):250~253
MR边界征及皮质征用于鉴别脑单发转移瘤与高级别星形细胞肿瘤
Boundary sign and cortex sign on MR in differentiation between solitary brain metastasis and astrocytoma
投稿时间:2009-06-01  修订日期:2009-10-21
DOI:
中文关键词:  星形细胞肿瘤  肿瘤转移  磁共振成像  诊断,鉴别
英文关键词:Astrocytoma  Neoplasm metastasis  Magnetic resonance imaging  Diagnosis, differential
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作者单位E-mail
罗海营 广东省人民医院放射科 广东省医学科学院,广东 广州 510080  
黄飚 广东省人民医院放射科 广东省医学科学院,广东 广州 510080  
刘红军 广东省人民医院放射科 广东省医学科学院,广东 广州 510080  
张水兴 广东省人民医院放射科 广东省医学科学院,广东 广州 510080  
王广谊 广东省人民医院放射科 广东省医学科学院,广东 广州 510080  
梁长虹 广东省人民医院放射科 广东省医学科学院,广东 广州 510080 dr_liang62@hotmail.com 
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中文摘要:
      目的 评价T1WI边界征及T2-FLAIR皮质征对鉴别单发转移瘤与高级别星形细胞肿瘤的价值。方法 高级别星形细胞肿瘤31例和单发脑转移瘤42例,均接受常规MR平扫及增强扫描,回顾性分析边界征和皮质征的出现几率。结果 73例中39例出现T1WI边界征,其中32例为单发转移瘤,7例为星形细胞肿瘤;边界征诊断单发转移瘤的敏感度和特异度分别为76.20%和77.42%,对单发转移瘤的阳性预测值是82.05%。34例出现T2-FLAIR皮质征,其中25例为星形细胞肿瘤,9例为单发转移瘤;皮质征诊断星形细胞肿瘤的敏感度和特异度分别是80.65%和78.57%,对星形细胞肿瘤的阳性预测值是73.53%。55例只出现一个征象,其中31例仅出现边界征,其中27例为单发转移瘤,4例为星形细胞肿瘤;24例仅出现皮质征,其中21例为星形细胞肿瘤,3例为单发转移瘤。两种征象联合应用的ROC曲线下面积为0.85。结论 边界征与皮质征分别是诊断脑单发转移瘤和星形细胞肿瘤较特异的征象,两者联合应用有助于提高二者的鉴别诊断准确率。
英文摘要:
      Objective To investigate the value of the boundary sign and cortex sign in differential diagnosis of solitary brain metastasis and astrocytoma. Methods Thirty-one patients with high grade astrocytoma and 42 patients with solitary brain metastasis diagnosed either pathologically or clinically were included in this study. The differential diagnostic value of the boundary and the cortex sign were analyzed retrospectively. Results The boundary sigh was found in 39 of 73 patients, which included 32 patients with solitary metastasis and 7 patients with astrocytoma. The sensitivity and specificity of the boundary sign was 76.20% and 77.42%, respectively, and the positive predictive value for solitary metastasis was 82.05%. The cortex sign was found in 34 of 70 patients, including 25 with astrocytoma and 9 with solitary metastasis. The sensitivity and specificity of the cortex sign was 80.65% and 78.57%, respectively, and the positive predictive value for astrocytoma was 73.53%. The boundary sigh was singlely foundin 24 patients, including 21 with astrocytoma and 3 with solitary metastasis. The area under the curve for both two signs was 0.85. Conclusion The boundary sign and the cortex sign are specific signs in differentiation between solitary brain metastasis and astrocytoma on routine MR series. Combination of this two signs is very useful in distinguishing solitary brain metastasis from astrocytoma.
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