动态增强MRI鉴别良、恶性软组织肿瘤的价值

发布时间：2018-03-08 13:44

本文选题：软组织肿瘤　切入点：磁共振成像　出处：《临床放射学杂志》2015年12期 　论文类型：期刊论文

【摘要】：目的探讨动态增强MRI鉴别良、恶性软组织肿瘤的价值。方法前瞻性搜集经手术病理证实的42例良、恶性软组织肿瘤的MRI资料。所有病例均行MRI平扫、增强及动态增强扫描,观察分析MRI异常征象特征及时间-信号强度曲线(TIC)的形态特点,计算最大强化率(ER_(max))和最大上升斜率(Slope_(max)),采用秩和检验分析两组间TIC及量化参数的差异,以病理结果为金标准,用ROC曲线下面积评价各动态参数的诊断效能。结果 17例恶性肿瘤动态增强扫描的TIC,14例呈快速上升型,3例呈上升平台型;25例良性肿瘤的TIC,4例呈快速上升型,13例呈上升平台型,8例呈延迟上升型。两组间的差异有高度统计学意义(Z值为4.229,P0.01)。恶性肿瘤ER_(max)为(458.43±351.40)%,Slope_(max)为(16.47±11.36)%/s。良性肿瘤ER_(max)为(284.64±265.35)%,Slope_(max)为(7.70±9.03)%/s。两组间ER_(max)和Slope_(max)的差异有统计学意义(Z值分别为1.961、3.203,P0.05、P0.01)。ER_(max)、Slope_(max)和两者联合的ROC曲线下面积分别为0.680、0.794和0.793,以最大约登指数为切入值,ER_(max)为298.33%、Slope_(max)为5.945%/s时,两者鉴别良、恶性软组织肿瘤的敏感性分别为58.82%和82.35%,特异性分别为76.00%和72.00%,两者联合应用的敏感性为94.12%,特异性为60.00%。结论动态增强MRI扫描的TIC及ER_(max)和Slope_(max)半量化指标有助于良、恶性软组织肿瘤的鉴别。
[Abstract]:Objective to investigate the dynamic enhanced MRI in differential diagnosis of benign and malignant soft tissue tumors value. Methods prospective pathologically confirmed 42 cases of benign and malignant soft tissue tumor MRI. All patients underwent MRI scan, enhanced and dynamic enhanced scanning, observation and analysis of abnormal MRI signs and the time signal intensity curve (TIC) morphological characteristics, the calculation of the maximum enhancement rate (ER_ (max)) and the maximum slope of increase (Slope_ (max)), the differences were analyzed using rank sum test and TIC quantitative parameters between the two groups, with pathological results as the gold standard to evaluate the performance of the dynamic parameters in the area under the ROC curve. The results of 17 cases malignant tumor of TIC dynamic contrast-enhanced scan, 14 cases showed a rapid rising type, 3 cases of upward platform type; 25 cases of benign tumor TIC, 4 cases of type 13 cases was rapidly rising, rising platform type, 8 cases showed delayed increase. The difference between the two groups was statistically significant (Z = 4. 229, P0.01). ER_ (max) for malignant tumors (458.43 + 351.40)%, Slope_ (max) is (16.47 + 11.36)%/s. ER_ (max) for benign tumors (284.64 + 265.35)%, Slope_ (max) is (7.70 + 9.03)%/s. ER_ in the two groups (max and Slope_) (max) there was a significant difference (Z = 1.961,3.203, P0.05, P0.01).ER_ (max), Slope_ (max) ROC curve area and combined the 0.680,0.794 and 0.793 respectively, with the maximum Youden index as the starting value, ER_ (max) 298.33%, Slope_ (max) 5.945%/s two, differential diagnosis of benign and malignant soft tissue tumors, the sensitivity were 58.82% and 82.35%, the specificity was 76% and 72%, the sensitivity of the combined application of both methods was 94.12%, the specificity of 60.00%. TIC and ER_ MRI conclusion dynamic enhanced scanning (max) and Slope_ (max) semi quantitative indicators help identify benign and malignant soft tissue tumors.

【作者单位】：皖南医学院附属弋矶山医院影像中心;
【分类号】：R445.2;R738.6

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