脑弥散角质成像在不同原发部位肿瘤转移的鉴别诊断中的应用

Natalia V. Garanina, Michail B. Dolgushin, L. M. Fadeeva, E. Pogosbekyan, Denis V. Sashin, E. A. Nechipay, Andrey V. Dvoryanchikov
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摘要

目的。本研究旨在通过在磁共振扫描方案中引入弥散峰度磁共振成像技术,提高不同原发部位肿瘤脑转移的鉴别诊断质量。 材料与方法:研究对象包括2019年10月至2022年3月期间在俄罗斯卫生部N.N. Blokhin命名的国家肿瘤学研究医疗中心接受检查和治疗的60名患者,根据磁共振成像,检测出原发肿瘤不同定位的脑实质转移灶。20名患者被诊断为肺癌(33.3%),20名患者被诊断为乳腺癌(33.3%),20名患者被诊断为黑色素瘤(33.3%)。3%).我们评估了肿瘤大小、弥散和峰度参数,如平均峰度(MK)、轴向峰度(AK)、径向峰度(RK)、峰度各向异性(KA)、径向弥散(RD)、分数各向异性(FA)、相对各向异性(RA)、轴外液体轴向扩散(ADEAF)、轴外液体径向扩散(RDEAF)、轴突液体分数(AFF)和扩散轨迹迂曲度(TTD)。 结果具有统计学意义(P0.05),在黑色素瘤和肺癌参数结构--轴向弥散(AD)、分数各向异性(FA)、相对各向异性(RA)、径向峰度(RK)和弥散轨迹迂曲度(ТTD)--的指标比较评估中发现了弥散和峰度参数的差异、)以及黑色素瘤和乳腺癌的结构--轴向扩散(AD)、轴突流体分数(FAF)、分数各向异性(FA)、轴外流体轴向扩散(ADEAF)、平均峰度(MK)、相对各向异性(RA)、径向峰度(RK)和扩散轨迹迂回度(TTD)。
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DIFFUSION-CURTOSIS MRI OF THE BRAIN IN DIFFERENTIAL DIAGNOSTICS OF METASTASES OF TUMORS OF VARIOUS PRIMARY LOCATION
OBJECTIVE. The aim of this study is to improve the quality of differential diagnosis of metastases in the brain of tumors of different primary localization by introducing the diffusion-kurtosis magnetic resonance imaging technique into the MR-scanning protocol. MATERIALS AND METHODS. The study included 60 patients who underwent examination and treatment at the National Research Medical Center of Oncology named by N.N. Blokhin of the Ministry of Health of Russia from October 2019 to March 2022, in which, according to magnetic resonance imaging, metastatic formations in the substance of the brain of different localization of the primary tumor were detected. 20 patients were diagnosed with lung cancer (33.3%), 20 patients with breast cancer (33.3%) and 20 patients with melanomas (33.3%). 3%). We evaluated the tumor size, diffusion and kurtosis parameters, such as mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), kurtosis anisotropy (KA), radial diffusion (RD), fractional anisotropy (FA), relative anisotropy (RA), axial diffusion of the extra-axonal fluid (ADEAF), radial diffusion of the extra-axonal fluid (RDEAF), axonal fluid fraction (AFF), and tortuosity of the diffusion trajectory (TTD). RESULTS. Statistically significant (p0.05) differing parameters of diffusion and kurtosis in the comparative evaluation of indicators were identified in the structure of melanoma and lung cancer parameters - axial diffusion (AD), fractional anisotropy (FA), relative anisotropy (RA), radial kurtosis (RK) and tortuosity of the diffusion trajectory (ТTD) ), as well as in the structure of melanoma and breast cancer - axial diffusion (AD), axonal fluid fraction (FAF), fractional anisotropy (FA), axial diffusion of extra-axonal fluid (ADEAF), mean kurtosis (MK), relative anisotropy (RA), radial kurtosis (RK) and tortuosity of the diffusion trajectory (TTD).
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