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Acta medica Medianae
2018, vol. 57, br. 3, str. 82-88
jezik rada: engleski
vrsta rada: originalan članak
doi:10.5633/amm.2018.0311
Creative Commons License 4.0
'Apparent diffusion coefficient-(ADC)' - peritumorskog tkiva kao diferencijalno dijagnostički marker moždanih metastaza u odnosu na gliome
Univerzitet u Nišu, Medicinski fakultet

e-adresa: zorad_yu@yahoo.com

Sažetak

Peritumorski edem kod visokogradusnih glioma predstavlja kombinaciju tumorske infiltracije i vazogenog edema, dok je peritumorski edem kod intrakranijalnih metastaza čisto vazogenog porekla. Cilj ove studije bio je da ispita da li ADC može biti korišćen kao neinvazivni parametar u diferencijaciji peritumorskog edema moždanog tkiva kod metastatskih promena i kod cerebralnih glioma. U ovoj prospektivnoj studiji analiziran je 71 bolesnik, 22 sa histoloski potvrđenim intrakranijalnim metastazama i 49 sa gliomima. Svi bolesnici su podvrgnuti konvencionalnom MRI i DWI sedam dana pre neurohirurške intervencije. ADC vrednosti su dobijene u tri regiona od interesa u okviru peritumorskog moždanog tkiva i upoređivane sa histopatoloskim nalazima. Prosečne minimalne vrednosti ADC u peritumorskom tkivu niskogradusnih glioma su bile značajno veće (< 0,001) u odnosu na vrednosti nađenih kod visokogradusnih glioma. Prosečne minimalne vrednosti ADC u peritumorskom tkivu kod cerebralnih metastaza su bile značajno više nego one nađene kod visokogradusnih glioma. ADC vrednosti peritumorskog moždanog tkiva kod metastaza karcinoma pluća (0,000947 ± 0,000043 mm2/s), melanoma (0,000842 ± 0,000018 mm2/s) i karcinoma dojke (0,000783 ± 0,000048 mm2/s) bile su značajno veće nego ADC vrednosti peritumorkog moždanog tkiva kod astrocitoma gradus I (0,000775 ± 0,000013 mm2/s), gradus II (0,000411 ± 0,000005 mm2/s), gradus III (0,000121 ± 0,000004 mm2/s) i glioblastoma multiforme (0,000076 ± 0,000011 mm2/s). Minimalne vrednosti ADC peritumorskog edema kod moždanih metastaza bile su značajno veće u odnosu na vrednosti kod glioma. ADC vrednosti mogu imati dodatnu dijagnostičku vrednost u razlikovanju glioma u odnosu na moždane metastaze.

Ključne reči

MRI; moždane metastaze; DWI; moždani gliomi

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