Diffusion-weighted imaging and susceptibility-weighted imaging in differentiating ring-enhancing primary central nervous system lymphoma from infections.

IF 1.3 Q4 NEUROIMAGING
Nutchawan Jittapiromsak, Phanuphong Sriinkua, Pornpattra Nimitpornsuko, Pakrit Jittapiromsak
{"title":"Diffusion-weighted imaging and susceptibility-weighted imaging in differentiating ring-enhancing primary central nervous system lymphoma from infections.","authors":"Nutchawan Jittapiromsak, Phanuphong Sriinkua, Pornpattra Nimitpornsuko, Pakrit Jittapiromsak","doi":"10.1177/19714009251354883","DOIUrl":null,"url":null,"abstract":"<p><p>IntroductionDifferentiating ring-enhancing primary central nervous system lymphoma (PCNSL) from infections is critical yet challenging in clinical practice. This study aimed to evaluate the effectiveness of diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI) in differentiating ring-enhancing PCNSL from infections.Material and MethodsWe retrospectively reviewed 78 ring-enhancing lesions in 32 patients who underwent brain magnetic resonance imaging (MRI). Qualitative and quantitative assessments of the peripheral and central regions of ring-enhancing lesions were independently performed. The qualitative assessment involved evaluating restricted diffusion on DWI and intralesional susceptibility signal (ISS) on SWI. The quantitative assessment involved comparing the apparent diffusion coefficient average (ADC<sub>avg</sub>) ratio and apparent diffusion coefficient minimum (ADC<sub>min</sub>) ratio of the peripheral and central regions with the final diagnosis.ResultsThe lesions consisted of PCNSL (<i>n</i> = 21), tuberculosis (<i>n</i> = 17), and toxoplasmosis (<i>n</i> = 40). The qualitative assessment showed that diffusion was significantly more restricted at the periphery in PCNSL (<i>p</i> < .001) and that ISS positivity was significantly higher both peripherally (<i>p</i> < .001) and centrally (<i>p</i> = .001) in PCNSL than in infections. The quantitative assessment revealed that PCNSL had significantly lower ADC<sub>avg</sub> (peripheral, <i>p</i> < .001; central, <i>p</i> = .01) and ADC<sub>min</sub> ratios (peripheral, <i>p</i> < .001; central, <i>p</i> = .025) compared to infections. A peripheral ADC<sub>avg</sub> ratio of <1.25 demonstrated the best diagnostic accuracy (area under the curve: 0.966, 95% confidence interval [CI]: 0.93-1.00, sensitivity: 85.7%, specificity: 89.5%, and accuracy: 88.5%) for differentiating PCNSL from infections.ConclusionRestricted diffusion on DWI, positive ISS on SWI, and ADC ratio measurements of ring-enhancing lesions demonstrate significant potential as adjunctive imaging features for distinguishing PCNSL from CNS infections.</p>","PeriodicalId":47358,"journal":{"name":"Neuroradiology Journal","volume":" ","pages":"19714009251354883"},"PeriodicalIF":1.3000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185441/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/19714009251354883","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NEUROIMAGING","Score":null,"Total":0}
引用次数: 0

Abstract

IntroductionDifferentiating ring-enhancing primary central nervous system lymphoma (PCNSL) from infections is critical yet challenging in clinical practice. This study aimed to evaluate the effectiveness of diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI) in differentiating ring-enhancing PCNSL from infections.Material and MethodsWe retrospectively reviewed 78 ring-enhancing lesions in 32 patients who underwent brain magnetic resonance imaging (MRI). Qualitative and quantitative assessments of the peripheral and central regions of ring-enhancing lesions were independently performed. The qualitative assessment involved evaluating restricted diffusion on DWI and intralesional susceptibility signal (ISS) on SWI. The quantitative assessment involved comparing the apparent diffusion coefficient average (ADCavg) ratio and apparent diffusion coefficient minimum (ADCmin) ratio of the peripheral and central regions with the final diagnosis.ResultsThe lesions consisted of PCNSL (n = 21), tuberculosis (n = 17), and toxoplasmosis (n = 40). The qualitative assessment showed that diffusion was significantly more restricted at the periphery in PCNSL (p < .001) and that ISS positivity was significantly higher both peripherally (p < .001) and centrally (p = .001) in PCNSL than in infections. The quantitative assessment revealed that PCNSL had significantly lower ADCavg (peripheral, p < .001; central, p = .01) and ADCmin ratios (peripheral, p < .001; central, p = .025) compared to infections. A peripheral ADCavg ratio of <1.25 demonstrated the best diagnostic accuracy (area under the curve: 0.966, 95% confidence interval [CI]: 0.93-1.00, sensitivity: 85.7%, specificity: 89.5%, and accuracy: 88.5%) for differentiating PCNSL from infections.ConclusionRestricted diffusion on DWI, positive ISS on SWI, and ADC ratio measurements of ring-enhancing lesions demonstrate significant potential as adjunctive imaging features for distinguishing PCNSL from CNS infections.

弥散加权成像和敏感性加权成像鉴别环增强原发性中枢神经系统淋巴瘤与感染。
在临床实践中,区分环增强型原发性中枢神经系统淋巴瘤(PCNSL)与感染是至关重要的,但也具有挑战性。本研究旨在评估扩散加权成像(DWI)和敏感性加权成像(SWI)在鉴别环增强PCNSL与感染中的有效性。材料与方法回顾性分析32例经脑磁共振成像(MRI)检查的78个环增强病灶。定性和定量评估外周和中心区域的环形增强病变独立进行。定性评价包括DWI上的受限扩散和SWI上的局内敏感性信号(ISS)。定量评价包括比较周围和中心区域的平均表观扩散系数(ADCavg)比和最小表观扩散系数(ADCmin)比与最终诊断结果。结果PCNSL 21例,结核17例,弓形虫病40例。定性评价结果显示,PCNSL外周区弥散明显受限(p < 0.001),与感染相比,PCNSL外周区(p < 0.001)和中央区(p = 0.001) ISS阳性明显升高。定量评价显示,PCNSL组ADCavg显著低于对照组(p < 0.001;中心,p = 0.01)和ADCmin比值(外周,p < 0.001;中心,p = 0.025),与感染相比。外围ADCavg比值为
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Neuroradiology Journal
Neuroradiology Journal NEUROIMAGING-
CiteScore
2.50
自引率
0.00%
发文量
101
期刊介绍: NRJ - The Neuroradiology Journal (formerly Rivista di Neuroradiologia) is the official journal of the Italian Association of Neuroradiology and of the several Scientific Societies from all over the world. Founded in 1988 as Rivista di Neuroradiologia, of June 2006 evolved in NRJ - The Neuroradiology Journal. It is published bimonthly.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信