磁共振弥散加权成像及波谱成像评价原发性骨肉瘤恶性程度

发布时间：2018-05-01 03:24

本文选题：骨肉瘤 + 扩散磁共振成像　；参考：《中国医学影像技术》2017年11期

【摘要】：目的探讨DWI和~1H-MRS对不同恶性程度原发性骨肉瘤的诊断价值。方法回顾性分析41例经病理证实的骨肉瘤患者的DWI和1 H-MRS检查资料。DWI检查中b值分别为0、400、800、1 000、1 500s/mm~2,经后处理获得相应的ADC图,并计算ADC值。对18例MRS谱线稳定的骨肉瘤患者进行分析并获得MRS谱线、胆碱复合物(Cho)、肌酸(Cr)及Cho/Cr值。不同b值下高度和低度恶性骨肉瘤的ADC值比较采用Kruskal-Wallis H检验,Cho/Cr值的比较采用Mann-Whitney U检验。结果当b值分别为400、800、1000s/mm~2时,高度与低度恶性骨肉瘤的ADC值差异有统计学意义(χ~2=6.26、4.37、4.87,P=0.01、0.04、0.03);而b值为1 500s/mm~2时,高度与低度恶性骨肉瘤ADC值差异无统计学意义(χ~2=2.39,P=0.12)。b值为400s/mm~2时,以ADC值诊断高度恶性骨肉瘤的特异度和敏感度为73.30%和72.70%。高、低度恶性骨肉瘤的Cho/Cr值差异有统计学意义(Z=-2.45,P0.05)。以Cho/Cr诊断高度恶性骨肉瘤的最佳界值为2.21,特异度为75.00%,敏感度为92.90%。结论 ADC值(b值取400s/mm~2)及Cho/Cr值均对诊断原发性骨肉瘤的恶性程度有一定价值。
[Abstract]:Objective to evaluate the diagnostic value of DWI and 1 H-Mrs in different malignant grade primary osteosarcoma. Methods 41 cases of pathologically proved osteosarcoma were retrospectively analyzed. The b values of DWI and 1 H-MRS were 0 400800 / 1 000 ~ 1 000 s / m ~ (-2) respectively. The corresponding ADC map was obtained by post-processing and the ADC value was calculated. The MRS spectra, choline complex, creatine Cr) and Cho/Cr values in 18 patients with osteosarcoma with stable MRS spectrum were analyzed. The ADC value of high and low degree malignant osteosarcoma was compared by Kruskal-Wallis H test and Mann-Whitney U test. Results when b was 400800 / 1000s / mm ~ 2, the ADC value of height was significantly different from that of low grade malignant osteosarcoma (蠂 ~ 2 ~ (6.26) 4.37 ~ 4.87), but there was no significant difference in ADC between height and low-grade malignant osteosarcoma (蠂 ~ (2 / 2) ~ (2.39) (蠂 ~ (2 / 2) ~ (2.39) P ~ (0.12) (蠂 ~ (2 / 2) = 4.37 ~ (4.87) P ~ (0.01) 0.04), but there was no significant difference in ADC value between height and low grade malignant osteosarcoma (蠂 ~ 2 = 2.39) (蠂 ~ 2 = 2.39) (P < 0.05 ~ 2). The specificity and sensitivity of ADC in diagnosis of high malignant osteosarcoma were 73.30% and 72.70% respectively. The Cho/Cr values of high and low grade malignant osteosarcoma had statistical significance. The best value of Cho/Cr for diagnosis of highly malignant osteosarcoma is 2.21, the specificity is 75.00, and the sensitivity is 92.90. Conclusion ADC and Cho/Cr are valuable in the diagnosis of malignant degree of primary osteosarcoma.
【作者单位】：郑州大学第一附属医院磁共振科;
【分类号】：R445.2;R738.1

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