体素内不相干运动弥散加权成像对儿童腹部良恶性肿瘤诊断价值

发布时间：2018-04-01 09:14

本文选题：磁共振成像　切入点：弥散加权　出处：《中国循证儿科杂志》2017年04期

【摘要】：目的运用体素内不相干运动(IVIM)弥散加权(DW)MRI的方法,探讨IVIM双指数参数鉴别儿童腹部良恶性肿瘤的价值。方法以儿童腹部肿瘤手术病理为金标准,术前1周内行IVIM DW-MRI检查为待测标准,对怀疑腹部肿瘤、不能完全确诊为良性肿瘤者行常规MRI(T1W、T2W和增强T1W)和DW序列。根据病理分为恶性组、良实性组、交界性组和良囊性组。选取b值范围0~800 s·mm~(-2),通过软件计算得到ADC值,使用肿瘤轮廓法勾画肿瘤的感兴趣区(ROI),计算D、D*和f值。结果 85例腹部肿瘤患儿(98个肿瘤)进入本文分析。男43例;平均年龄4.4岁;恶性组(52例,62块),交界性组(7例,7块),良实性组(21例,24块),良囊性组(5例,5块);ROI平均值12.9(1.3~26.1)cm~2。ADC、D和D~*均体现在恶性组最低,交界性组、良实性组和良囊性组依次升高,差异均有统计学意义;ADC、D和D*在恶性与非恶性肿瘤(实性+囊性)差异均有统计学意义;鉴别恶性和良实性肿瘤Cutoff(×10~(-6)mm~2·s~(-1))分别为1 367、1 056和1 605,ADC鉴别的特异度高(85.5%),D值鉴别的灵敏度高(83.3%),鉴别恶性和实性肿瘤(良实性+交界性)、恶性和非恶性肿瘤(良实性+交界性+良囊性)Cutoff(×10~(-6)mm~2·s~(-1))分别为1 173、1 014和1 634;鉴别恶性和实性肿瘤(良实性+交界性)ADC和D值特异度较好(87.1%和83.9%),鉴别恶性和非恶性肿瘤(良实性+交界性+良囊性),ADC、D和D~*值特异度均良好(88.9%、86.1%和80.6%)。结论 IVIM DW-MRI中的ADC和D值对鉴别儿童腹部良恶性肿瘤有较好的诊断价值。
[Abstract]:Objective to evaluate the value of IVIM double index parameters in differentiating benign and malignant abdominal tumors in children with diffusion-weighted Mr imaging.Methods the surgical pathology of abdominal tumors in children was taken as the golden standard, and the IVIM DW-MRI examination was performed within 1 week before operation. The patients suspected of abdominal tumors who could not be completely diagnosed as benign tumors were treated with routine MRI T1WT 2W and enhanced T 1W) and DW sequences.According to pathology, they were divided into malignant group, good solid group, borderline group and benign cystic group.The ADC value was calculated by software, and the ROI value of the region of interest of the tumor was delineated by using the tumor contour method, and the values of DU D * and f were calculated by using the b value range of 0 ~ 800s / mm ~ (-1) ~ (-1) ~ (-1).Results 85 children with abdominal tumors (98 tumors) were included in this analysis.The mean age was 4.4 years old, the mean age was 4.4 years old, the mean value of ROI in malignant group (n = 52), borderline group (n = 7), benign group (n = 21), benign and solid group (n = 21) and benign cystic group (n = 5) were 12.91.3n 26.1 cm ~ (-1). 2. ADCD and D* were found in the lowest and borderline group.The difference of ADCD and D * between malignant and non-malignant tumors (solid cystic) was statistically significant.The specificity was 86.1% and 80.6% respectively.Conclusion the ADC and D values in IVIM DW-MRI are valuable for the differential diagnosis of benign and malignant abdominal tumors in children.
【作者单位】：复旦大学附属儿科医院放射科;浙江省宁波市第一医院放射科;复旦大学附属儿科医院病理科;
【基金】：上海市科学技术委员会西医引导项目:134119a4100 上海申康医院发展中心临床辅助科室能力(影像医学)建设项目:SHDC22015031
【分类号】：R445.2;R730.44

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