对比分析多层螺旋CT与MRI扩散加权成像诊断四肢软组织肿瘤的价值

发布时间：2018-04-09 12:37

本文选题：四肢肿瘤　切入点：多层螺旋CT　出处：《实用医学杂志》2014年05期

【摘要】：目的:对比分析多层螺旋CT与MRI扩散加权成像对于四肢软组织肿瘤的诊断价值。方法:对于104例原发性四肢软组织肿瘤,均行CT检查和MRI检查,所有病例均经手术病理证实。CT检查中比较各类肿瘤的CT值。MRI检查中,MRI扩散加权成像的扩散敏感因子(b值)选取0,500 s/mm2,操作时尽量避开出血、坏死、瘢痕、钙化等不均质成分区,选取肿瘤实体部分最大感兴趣区,比较良、恶性肿瘤和肌肉组织的表观扩散系数(apparent diffusion coefficient,ADC)的差异。结果:在所有104例患者中,良性68例,恶性36例。CT检查与病理相符45例,MRI相符87例;定性错误和未定性:CT 59例,MRI 17例。软组织肿瘤在CT上显示为低密度肿块,其中脂肪瘤和囊肿表现具有特异性;MRI中,不同类型肿瘤的T1WI和T2WI表现差异较大,而恶性肿瘤的ADC值显著低于良性肿瘤和肌肉组织(P0.01);但良性肿瘤和肌肉组织的ADC缺乏显著差异(P0.05)。CT和MRI的检测水平比较,P0.01。结论:CT能够清楚显示四肢软组织肿瘤病灶,并明确其和周围组织关系,但无法进行准确定性;MRI扩散加权成像可以更好地鉴别良恶性,并推测病变组织学来源。MRI检测水平显著高于CT,与病理相符度更高。因而在四肢软组织肿瘤的术前诊断中,应首选MRI扩散加权成像。
[Abstract]:Objective: to compare and analyze the diagnostic value of multislice spiral CT and MRI diffusion-weighted imaging in soft tissue tumors of extremities.Methods: 104 cases of primary soft tissue tumors of extremities were examined by CT and MRI.All cases were confirmed by operation and pathology. The CT value of all kinds of tumors was compared. The diffusion-sensitive factor of diffusion-weighted imaging in MRI was 0500 s / mm ~ (2). The operation should avoid bleeding, necrosis, scar, calcification, etc.The difference of apparent diffusion coefficient (diffusion) of benign, malignant and muscle tissues was compared.Results: among 104 patients, 68 cases were benign, 36 cases were malignant. Ct was consistent with pathology in 45 cases (87 cases), qualitative error and uncertainty in 59 cases (17 cases).Soft tissue tumors showed low density masses on CT, among which lipomas and cysts showed specific MRI findings. The T1WI and T2WI findings of different types of tumors varied greatly.The ADC value of malignant tumor was significantly lower than that of benign tumor and muscle tissue (P 0.01), but there was no significant difference in ADC between benign tumor and muscle tissue.Conclusion the tumors of the soft tissue of the extremities can be clearly demonstrated by Mr imaging, and the relationship between them and the surrounding tissues can be determined, but the diffusion weighted imaging of MRI can better distinguish benign and malignant tumors from benign ones.It was speculated that the detection level of MRI was significantly higher than that of CT, and the degree of coincidence with pathology was higher.Therefore, MRI diffusion-weighted imaging should be the first choice in preoperative diagnosis of soft tissue tumors in extremities.
【作者单位】：武汉市普爱医院放射科;武汉市中心医院放射科;广州军区武汉总医院放射科;
【分类号】：R738.6;R445

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