探讨磁共振扩散加权成像在鉴别良恶性椎体骨折中的诊断价值

发布时间：2018-02-27 02:27

本文关键词： 扩散加权成像脊柱骨折鉴别诊断　出处：《临床放射学杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨磁共振扩散加权成像(DWI)在良恶性椎体骨折中的鉴别诊断价值。方法根据临床随访和病理资料将29例椎体骨折患者分为两组,良性组(15例)为急性良性骨折,恶性组(14例)为病理性骨折,对所有患者进行脊柱DWI检查,分别记录病灶和正常椎体的表观扩散系数(ADC)值,包括最大值、最小值和平均值,计算其差值(da、di、de),分析比较两组的ADC值、差值,并绘制受试者工作特征(ROC)曲线。结果恶性组较良性组的ADC最大值(1.55×10~(-3)mm~2/s vs.1.99×10~(-3)mm~2/s,P0.01)、ADC最小值(0.55×10~(-3)mm~2/s vs.0.79×10~(-3)mm~2/s,P0.05)、ADC平均值(1.08×10~(-3)mm~2/s vs.1.47×10~(-3)mm~2/s,P0.01)及最大值差值da(1.08×10~(-3)mm~2/s vs.1.58×10~(-3)mm~2/s,P0.01)、最小值差值di(0.52×10~(-3)mm~2/s vs.0.78×10~(-3)mm~2/s,P0.01)、平均值差值de(0.93×10~(-3)mm~2/s vs.1.32×10~(-3)mm~2/s,P0.01)要低。绘制ROC曲线后,病灶ADC最大值、最小值、平均值及其与正常椎体ADC的差值da、di、de的曲线下面积(AUC)分别为0.809,0.791,0.864,0.821,0.824,0.880。结论定量分析ADC值有助于鉴别椎体良恶性骨折,差值de的鉴别诊断准确性最高,病灶ADC平均值其次。
[Abstract]:Objective to investigate the value of DWI in differential diagnosis of benign and malignant vertebral fractures. Methods 29 patients with vertebral fractures were divided into two groups according to clinical follow-up and pathological data. 14 cases of malignant fracture were treated with spinal DWI. The apparent diffusion coefficient (ADCC) of the lesion and normal vertebral body was recorded, including the maximum, minimum and average values, and the difference was calculated. The ADC values of the two groups were analyzed and compared. Results the maximum value of ADC in malignant group was 1.55 脳 10 ~ (-3) mm ~ (-1) and the minimum value was 0.55 脳 10 ~ (-3) mm ~ (-2) vs.0.79 脳 10 ~ (-3) mm ~ (-2) vs.0.79 脳 10 ~ (-3) mm ~ (-3) mm). The average value of ADC in malignant group was 1.08 脳 10 ~ (-3) mm ~ (-2) vs.1.47 脳 10 ~ (-3) mm P ~ (0.01) and the maximum value was da(1.08 脳 10 ~ (-2) / s vs.1.58 脳 10 ~ (-2) s vs.1.58 脳 10 ~ (-2) s P ~ (0.01), and the minimum difference was 10 脳 10 ~ (-2) mm 脳 10 ~ (-2) -10 ~ (-2) m ~ (-1) di(0.52 脳 10 ~ (-2) mm 脳 10 ~ (-2)% -10 ~ (-1) -10 ~ (-1)% -10 ~ (-1) mm) of di(0.52 脳 10 ~ (-2) -10 ~ (-2) -10 ~ (-10) -P = -10 ~ (-1). The average value of ADC in malignant group was 1.08 脳 10 ~ (-3) mm ~ (-3) mm ~ (-3) mm ~ (-3) mm ~ (-1)) and the maximum value was 1.55 脳 10 ~ (-3) mm ~ (-3) mm ~ (-1) vs.1.99 = -10 ~ (-10) -3 mm ~ (-3) mm ~ (-1). The maximum and minimum values of ADC, the mean value and the area under the curve of the difference between the ADC of the lesion and the normal vertebral body were 0.809 / 0.791 / 0.864 / 0.824 / 0.880 respectively. Conclusion the quantitative analysis of ADC value is helpful for the differential diagnosis of benign and malignant fractures of vertebral body, and the differential value de is the most accurate in differential diagnosis. The mean value of ADC was the second.
【作者单位】：上海交通大学附属第六人民医院放射科;
【分类号】：R445.2;R683;R738

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