CHẨN ĐOÁN PHÂN BIỆT U NGUYÊN BÀO THẦN KINH ĐỆM VÀ DI CĂN NÃO ĐƠN Ổ: GIÁ TRỊ CỦA CỘNG HƯỞNG TỪ KHUẾCH TÁN SỨC CĂNG VÀ ĐỊNH LƯỢNG TÍN HIỆU TRÊN CHUỖI XUNG FLAIR

Abstract

Purpose: The purpose of this study is to investigate the diagnostic utility of difusion tensor imaging (DTI) and fluid-attenuated inversion recovery (FLAIR) in differentiating between glioblastoma (GBM) and solitary metastasis (MET) by analyzing fractional anisotropy (FA), mean diffusivity (MD) value of DTI and FLAIR signal intensity. Materials and methods: Fifty patients with GBM and MET who underwent conventional and DTI on 3 Tesla MRI, surgery or biopsy and had histopathologic reports at the Viet Duc Hospital were retrospectively reviewed. Three regions of interest (ROI) were placed in the enhancement region of the tumor, the peritumoral edema, and the opposite normal white matter on FA map, MD map and FLAIR in order to measure FA, MD value and signal intensity. The diagnostic value of the significant difference parameters between two entities was analyzed by using the receiver operating characteristic (ROC) curve. Results: In the peritumoral region, FA value (qFA) of GBM was significantly greater but the FLAIR signal (qFLAIR) was lower than that of MET (p<0,05). The FA, MD values, FLAIR signal in the enhancing region (uFA, uMD, uFLAIR) and the ratio of FA value between the enhancing region to opposite normal white matter (u/tFA) in GBM were both significantly greater than those of MET (p<0,05). Combining the uFA, uMD, uFLAIR, u/tFA, u/tFLAIR, qFA values provided the highest area under the curve (AUC) of 0,975, the sensitivity 88,6% and specificity 100% in distinguishing GBM and MET. Conclusions: The uFA, uMD, uFLAIR, u/tFA, u/tFLAIR, qFA are useful parameters for differentiation between GBM and MET. The combination of those values may increase the diagnostic performance.