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中文摘要：
目的：探讨MR弥散张量成像（ DTI）在瘤样炎性脱髓鞘病（ TIDD）与低级别胶质瘤（ LGG）鉴别诊断中的应用价值。方法纳入2012年1月—2016年2月在重庆医科大学附属第一医院确诊的10例TIDD患者及15例经病理证实的LGG患者资料进行回顾性分析。所有患者行3.0 T MR DTI检查,在表观弥散系数（ADC）图及部分各向异性（FA）图上定量测定患者病变区及其对侧镜像部位正常脑白质区（镜像区）的 ADC 值及 FA值,并进行统计分析；同时重建白质纤维素的3D图像,观察白质纤维素与病变区的空间位置关系。结果 TIDD组病变区和镜像区的ADC值、FA值分别为（1.484±0.14）×10^3 mm^2/s、0.109±0.02和（0.725±0.05）×10^3 mm^2/s、0.443±0.08,LGG组病变区和镜像区的ADC值、FA值分别为（1.368±0.09）×10^3 mm^2/s、0.163±0.01和（0.684±0.03）×10^3 mm^2/s、0.471±0.04。 TIDD组与LGG组两组内病变区与镜像区ADC值和FA值差异均有统计学意义（P值均〈0.01）,组间病变区ADC值和FA值差异均有统计学意义（P值均〈0.05）。LGG的纤维重建图主要表现为肿瘤部位明显受压外移,较对侧稀疏、中断及形态改变；TIDD的纤维重建图主要表现为纤维稍稀疏,未见明显中断及移位改变。结论 TIDD与LGG在DTI上的弥散指标存在明显差异,可为两者的鉴别诊断提供量化依据。
英文摘要：
Objective To investigate the application of diffusion tensor imaging （ DTI ） in the differential diagnosis of tumor-like inflammatory demyelinating disease（ TIDD） and low grade glioma（ LGG） . Methods Ten cases of TIDD and 15 cases of LGG, verified by operation and pathology performed by using 3. 0 T DTI in the First Affiliated Hospital of Chongqing Medical University from January 2012 to February 2012 were retrospectively studied. Apparent diffusion coefficient（ ADC） values and fractional （ FA） values were measured on the placeholder district and the contralateral normal brain white matter on ADC and FA imaging of each patient and the results were statistically analyzed, the 3D image of white matter fiber was reconstructed, the relationship between lesion area and white matter pathways was observed. Results The ADC and FA values of TIDD in lesion area and the contralateral area were （1. 484 ± 0. 14） ×10^3 mm^2/s, 0. 109 ± 0. 02 and （0. 725 ± 0. 05） ×10^3 mm^2/s, 0. 443 ± 0. 08. The ADC and FA values of LGG in lesion area and the contralateral area were （1. 368 ± 0. 09） ×10^3 mm^2/s, 0. 163 ± 0. 01 and （0. 684 ± 0. 03） ×10^3 mm^2/s, 0. 471 ± 0. 04. The difference of ADC and FA values in lesion area between TIDD groups and LGG groups was significant compared with the contralateral area （all P values〈0. 01）. The difference of ADC and FA values in lesion area between the two groups was also significant （all P values〈0. 05）. The main features of LGG reconstruction of the fiber image were that the tumor site was obviously compressed and shifted, which was more sparse than the contralateral side. The main performance of TIDD was that the fiber was a little sparse, and there was no obvious interruption and shift. Conclusions The diffusion index of DITT and LGG in DTI shows significant differences, which provides quantitative basis in the differential diagnosis of two diseases.
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