MRI in differential diagnosis of primary central nervous system lymphoma and high grade glioma in deep brain / 中国介入影像与治疗学

ABSTRACT

Objective To explore the value of MRI in differential diagnosis of primary central nervous system lymphoma (PCNSL) and high grade glioma (HGG) in deep brain.Methods Features of routine MRI and DWI of 28 PCNSL (PCNSL group) and 30 HGG patients (HGG group) with single lesion in deep brain confirmed clinically and pathologically were analyzed,then apparent diffusion coefficient (ADC) and relative ADC (rADC) were measured.The optimal diagnostic threshold (OT) and diagnostic performance of ADC and rADC values were calculated according to the ROC curve.Results The incidence of capsule,necrosis,hemorrhage,enhancement heterogeneity and DWI signal strength were significantly different between the two groups (all P＜0.05).ADC values were statistically different between lesions and the control side of the brain white matter in PCNSL and HGG patients (both P＜0.001).ADC values and rADC values of PCNSL lesions were significantly lower than those of HGG lesions (all P＜0.001).Taking ADC=0.86 × 10-3 mm2/s as a threshold,the sensitivity,specificity and accuracy in differential diagnosis of PCNSL and HGG was 92.9％,80.0％ and 86.2％,respectively,and the area under curve was 0.946 (P＜ 0.001).Taking rADC =1.02 as a threshold,the sensitivity,specificity and accuracy in differential diagnosis of PCNSL and HGG was 92.9％,86.7％ and 89.7％,respectively,and the area under curve was 0.957 (P＜0.001).Conclusion MRI differential diagnosis can provide reliable information for clinical treatment of PCNSL and HGG in deep brain.