磁共振体素内不相干性运动在肌骨系统肿瘤定性诊断中的作用

发布时间：2018-11-08 20:32

【摘要】：目的:评价磁共振体素内不相干性运动(IVIM)参数在肌骨系统肿瘤定性诊断中的价值。方法:本研究中的38例肌骨系统肿瘤的患者,均采用1.5T MR扫描仪进行检查,在常规扫描后进行IVIM扫描。IVIM使用的9个b值分别为0,20,40,60,80,100,250,500和750s/mm2。分别测量病变区和作为对照组的正常肌肉组织IVIM参数ADC、ADCslow、ADCfast及PF值。根据病理结果,将病变分为良性(12例)、交界性(14例)及恶性肿瘤(12例),并对三组肿瘤之间以及肿瘤与对照组之间ADC、ADCslow、ADCfast及PF值的差异进行统计学分析。结果:交界性肿瘤的ADC及ADCslow值分别为(1.02±0.15)×10-3 mm2/s和(1.02±0.16)×10-3 mm2/s,明显低于对照组(1.38±0.20)×10-3 mm2/s和(1.38±0.17)×10-3 mm2/s,差异具有统计学意义(P=0.001)。恶性肿瘤的ADC及ADCslow值分别为(0.90±0.13)×10-3 mm2/s和(0.88±0.14)×10-3 mm2/s,明显低于对照组(1.48±0.12)×10-3 mm2/s和(1.48±0.09)×10-3 mm2/s,差异具有统计学意义(P0.001)。而良性肿瘤的ADC及ADCslow与对照组之间差异无统计学意义(P=0.564,0.480)。ADCfast以及PF值在肿瘤与对照组之间无统计学差异。交界性、恶性肿瘤的ADC和ADCslow值明显低于良性肿瘤,差异具有统计学意义(P值均0.001),但交界性肿瘤与恶性肿瘤之间的ADC和ADCslow值差异无统计学意义。良性、交界性和恶性肿瘤之间的ADCfast和PF值的差异没有统计学意义。结论:IVIM参数ADC和ADCslow有助于区分良性肿瘤与交界性、恶性肿瘤,提高肌骨系统肿瘤的诊断准确性。
[Abstract]:Objective: to evaluate the value of (IVIM) parameters in the qualitative diagnosis of myoskeletal tumors. Methods: 38 patients with myoosseous tumors were examined by 1.5T MR scanner, and IVIM scans were performed after routine IVIM scanning. The b values of IVIM were 0 ~ 20 / 40 ~ (60) ~ 80100 ~ 250500 and 750 s / m ~ (2) mm ~ (2), respectively. The IVIM parameters ADC,ADCslow,ADCfast and PF were measured in the lesion area and the normal muscle tissue as control group. According to the pathological results, the lesions were divided into benign (12 cases), borderline (14 cases) and malignant tumors (12 cases). The differences of ADC,ADCslow,ADCfast and PF between the three groups and the control group were analyzed statistically. Results: the ADC and ADCslow values of borderline tumors were (1.02 卤0.15) 脳 10-3 mm2/s and (1.02 卤0.16) 脳 10-3 mm2/s, respectively. It was significantly lower than that in the control group (1.38 卤0.20) 脳 10-3 mm2/s and (1.38 卤0.17) 脳 10-3 mm2/s, (P0. 001). The ADC and ADCslow values of malignant tumors were (0.90 卤0.13) 脳 10-3 mm2/s and (0.88 卤0.14) 脳 10-3 mm2/s, respectively, lower than those of the control group (1.48 卤0.12) 脳 10-3 mm2/s and (1.48 卤0.09) 脳 10-3 mm2/s, respectively. The difference was statistically significant (P0.001). However, there was no significant difference in ADC and ADCslow between benign tumor and control group (P < 0. 564 or 0. 480). ADCfast) and PF value was not significantly different between tumor and control group. The values of ADC and ADCslow in borderline and malignant tumors were significantly lower than those in benign tumors (P < 0.001), but there was no significant difference in ADC and ADCslow between borderline tumors and malignant tumors. There was no significant difference in ADCfast and PF between benign, borderline and malignant tumors. Conclusion: ADC and ADCslow parameters of IVIM are helpful to distinguish benign tumor from borderline malignant tumor and to improve the diagnostic accuracy of myoskeletal system tumor.
【作者单位】：北京积水潭医院放射科;西门子医疗有限公司MR事业部;
【基金】：北京市卫生系统高层次卫生技术人才培养项目(2009-02-03;2013-3-033)
【分类号】：R445.2;R738

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