MR动态增强对于中轴骨脊索瘤和骨巨细胞瘤的鉴别诊断价值的初步研究

发布时间：2018-03-17 07:26

本文选题：脊椎肿瘤　切入点：脊索瘤　出处：《中国医学影像学杂志》2016年08期 　论文类型：期刊论文

【摘要】：目的探讨MR T1WI动态增强成像半定量和定量分析对中轴骨脊索瘤和骨巨细胞瘤鉴别诊断的价值。资料与方法收集2008年6月—2013年10月于北京大学第三医院放射科进行MR T1WI动态增强扫描并经病理证实的中轴骨13例脊索瘤和17例骨巨细胞瘤患者,对两者后处理分析得到的信号强度-时间曲线类型及应用双室药物代谢动力学分析获得的转运常数(K~(trans))和速率常数(k_(ep))进行统计学分析。结果 13例脊索瘤中,9例(69.2%)为持续上升型,4例(30.8%)为平台型;17例骨巨细胞瘤患者中,11例(64.7%)为速升速降型曲线,6例(35.3%)为平台型曲线。骨巨细胞瘤Ktrans明显高于脊索瘤K~(trans)[(0.1247±0.0747)/min比(0.0603±0.0411)/min,P0.01];骨巨细胞瘤的k_(ep)明显高于脊索瘤的k_(ep)[(0.6629±0.2272)/min比(0.1736±0.1184)/min,P0.01]。以K~(trans)为0.0777/min作为诊断骨巨细胞瘤的阈值时,其诊断的敏感度、特异度分别为89.5%、76.9%;以k_(ep)为0.4339/min作为诊断骨巨细胞瘤的阈值时,其诊断的敏感度、特异度分别为94.7%、100.0%。ROC分析K~(trans)诊断骨巨细胞瘤的曲线下面积为0.826,k_(ep)诊断骨巨细胞瘤的曲线下面积为0.980。结论MR T1WI动态增强成像可以为常规影像学诊断困难的中轴骨脊索瘤和骨巨细胞瘤的鉴别诊断提供一定的参考。
[Abstract]:Objective to investigate the value of semi-quantitative and quantitative analysis of Mr T1WI dynamic contrast-enhanced imaging in the differential diagnosis between chordoma of the axial bone and giant cell tumor of bone. Materials and methods the data and methods were collected from June 2008 to October 2013 in the Department of Radiology, third Hospital of Peking University. 13 cases of chordoma of the axial bone and 17 cases of giant cell tumor of bone were examined by dynamic contrast-enhanced Mr T1WI and confirmed by pathology. The types of signal intensive-time curves obtained by post-processing analysis and the transport constants (K) and rate constants (K) obtained by two-compartment pharmacokinetic analysis were analyzed statistically. Results in 13 chordoma cases, 9 cases (69.2%) were found. In 17 cases of giant cell tumor of bone, 11 cases (64.7%) and 6 cases (35. 3%) were platform type. The Ktrans of giant cell tumor of bone was significantly higher than that of chordoma (0. 1247 卤0. 074 7 / min vs 0. 0603 卤0. 041 卤0. 01 min / min P0.01); the KepP of giant cell tumor of bone was significantly higher than that of chordoma (P < 0. 05. 01), and that of giant cell tumor of bone was significantly higher than that of chordoma (P < 0. 0603 卤0. 041 min / min, P < 0. 01), and that of giant cell tumor of bone was significantly higher than that of chordoma. For chordoma (0.6629 卤0.2272 / min vs 0.1736 卤0.1184 / min / min P0.01). The sensitivity and specificity of the diagnosis were 89.5% and 76.9%, respectively, and the sensitivity of the diagnosis of giant cell tumor of bone was determined when the threshold value was 0.4339 / min. The area under the curve of diagnosis of giant cell tumor of bone is 0.826 kepepp.) the area under curve of diagnosis of giant cell tumor of bone is 0.980. Conclusion dynamic contrast-enhanced imaging on Mr T1WI can be used to diagnose medial chordoma of bone with difficulty in conventional imaging. The differential diagnosis of giant cell tumor of bone provides some reference.
【作者单位】：北京大学第三医院放射科;加利福尼亚大学Tu&Yun肿瘤功能成像中心;
【基金】：国家自然科学基金(81471634) 北京市自然科学基金(7164309)
【分类号】：R445.2;R738.1

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