Tumors in pediatric patients at diffusion-weighted MR imaging: Apparent diffusion coefficient and tumor cellularity
Tumors in pediatric patients at diffusion-weighted MR imaging: Apparent diffusion coefficient and tumor cellularity
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DOI：
10.1148/radiol.2452061535
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发表时间：
2007-12-01
期刊：
影响因子：
19.7
通讯作者：
Olsen, Oystein E.
中科院分区：
文献类型：
--
作者：
Humphries, Paul D.;Sebire, Neil J.;Olsen, Oystein E.
目的：前瞻性评价表观弥散系数（apparent diffusion coefficient， ADC）与组织病理细胞计数之间是否存在相关性，以及ADC是否能够鉴别儿童颅内外肿块的良恶性。材料与方法：获得机构伦理批准及家长或监护人同意。19名儿童（11名女孩，8名男孩，年龄中位数为3.9岁，年龄范围为11天至15.5岁）接受了颅内外肿块的磁共振（MR）成像，包括弥散加权序列（b值为0、500和1000秒/毫米(2)），并进行了组织病理学分析以证明其发现。将每个肿块病变内的中位ADC与标本中10个高倍显微镜视野的中位细胞计数进行比较。计算细胞计数与ADC之间的负相关关系。采用Mann-Whitney U检验评估良、恶性病变间ADC的差异。结果：ADC与细胞计数呈反比关系，表示为ADC(以x 10（-3) mm(2)/sec计）= 0.56 +/-（66.2/细胞计数），与观测数据拟合较好（方差分析R-2 = 0.541, F = 20.0, P < 0.001）。良性病变的adc范围为（0.84-2.83）× 10(-3) mm(2)/sec(中位数为1.35 × 10(-3) mm(2)/sec；标准差，0.68)。恶性病变的adc范围为（0.73-1.53）× 10(-3) mm2/sec(中位数为1.00 × 10(-3) mm(2)/sec；标准差0.29)。良、恶性病变间ADC无显著差异（Mann-Whitney U = 22, P = 0.069）。所有高细胞（每高倍视场约150个细胞）病变的ADC均低于1.5 x 10(-3) mm(2)/秒。结论：虽然细胞数量与ADC之间存在显著关系，但细胞数量可能不是ADC的唯一决定因素。使用ADC不能准确区分恶性和良性病变。
Purpose: To prospectively assess whether there is a relationship between the apparent diffusion coefficient (ADC) and the histopathologic cell count and whether the ADC can enable differentiation of benign and malignant extracranial mass lesions in children.Materials and Methods: Institutional ethics approval and parent or guardian consent were obtained. Eleven malignant and eight benign lesions in 19 children (11 girls, eight boys; median age, 3.9 years; age range, 11 days to 15.5 years) who underwent magnetic resonance (MR) imaging of extracranial mass lesions-including a diffusion-weighted sequence (with b values 0, 500, and 1000 sec/mm(2)) - and histopathologic analysis to prove findings were studied. The median ADC within each mass lesion was compared with the median cell count for 10 high-power microscopic fields in the specimen. The inverse regression between cell count and ADC was calculated. The difference in ADC between benign and malignant lesions was assessed by using the Mann-Whitney U test.Results: There was an inverse relationship between ADC and cell count, expressed as ADC (in x 10(-3) mm(2)/sec) = 0.56 +/- (66.2/cell count), with a relatively good fit to the observed data (analysis of variance R-2 = 0.541, F = 20.0, P < .001). The ADCs of benign lesions ranged from (0.84-2.83)x 10(-3) mm(2)/sec (median, 1.35 x 10(-3) mm(2)/sec; standard deviation, 0.68). The ADCs of malignant lesions ranged from (0.73-1.53) x 10(-3) mm2/sec (median, 1.00 x 10(-3) mm(2)/sec; standard deviation, 0.29). There was no significant difference in ADC between benign and malignant lesions (Mann-Whitney U = 22, P = .069). All highly cellular (> 150 cells per high-power field) lesions had an ADC lower than 1.5 x 10(-3) mm(2)/sec.Conclusion: Although there is a significant relationship between cellularity and ADC, cell count probably is not the sole determinant of the ADC. Use of the ADC cannot enable accurate differentiation of malignant and benign lesions.