低度和高度恶性原发性骨肉瘤患者磁共振DWI、MRS、DCE检查结果对比分析

发布时间：2018-05-15 06:27

  本文选题：骨肉瘤 + 磁共振　； 参考：《山东医药》2017年23期

【摘要】：目的对比低、高度恶性原发性骨肉瘤患者磁共振弥散加权成像(DWI)、磁共振波谱成像(MRS)、动态增强扫描(DCE)检查结果,探讨低、高度恶性原发性骨肉瘤患者磁共振DWI、MRS、DCE检查结果的特点。方法将41例骨肉瘤患者分为低度恶性组和高度恶性组,病灶均行DWI、1H-MRS、DCE检查。DWI序列选用5个不同的弥散敏感系数(b值),分别是0、400、800、1 000、1 500 s/mm2,经后处理得到相应的表观弥散系数(ADC)图,选择感兴趣区计算ADC值,比较不同b值下低、高度恶性原发性骨肉瘤患者病灶的ADC值。对18例MRS谱线稳定的骨肉瘤患者病灶的MRS谱线进行分析,计算Cho/Cr值,比较低、高度恶性原发性骨肉瘤患者病灶的Cho/Cr值,用受试者工作曲线确定用Cho/Cr值鉴别低、高度恶性原发性骨肉瘤的最佳诊断界值。绘制病灶DCE的时间-信号强度曲线(TIC),比较低、高度恶性原发性骨肉瘤患者病灶TIC类型的差异。结果低度恶性组、高度恶性组病灶ADC0-400分别为(1 100.00,1875.00)、(977.25,1 434.00),ADC0-800分别为(51.00,1 410.00)、(844.75,1 259.00),ADC0-1000分别为(939.00,1 246.00)、(791.75,1122.50),ADC0-1500分别为(799.00,1 100.00)、(654.75,969.50),两组患者病灶ADC0-400、ADC0-800、ADC0-1000相比,P均0.05。18例骨肉瘤患者病灶MRS谱线均出现Cho峰,7例未出现Lip峰。高、低度恶性骨肉瘤患者病灶的Cho/Cr值分别是(2.703,4.883)、(1.045,2.695)。高、低度恶性骨肉瘤患者病灶的Cho/Cr值相比有统计学差异(Z=-2.445,P0.05)。以Cho/Cr值作为诊断指标绘制ROC曲线,曲线下面积为0.718,特异度为66.7%,敏感度为72.2%,最佳诊断界值为Cho/Cr=2.3。低度恶性组病灶TIC类型为Ⅰ型2例、Ⅱ型5例,Ⅲ型4例,高度恶性组分别为20、10、0例。两组病灶TIC类型分布相比,χ~2值为10.876,P0.05。结论高度恶性原发性骨肉瘤患者病灶DWI检查ADC值低于低度恶性原发性骨肉瘤患者。高度恶性原发性骨肉瘤患者病灶MRS检查Cho/Cr值高于低度恶性原发性骨肉瘤患者。以Cho/Cr=2.3为界值可以鉴别低、高度恶性原发性骨肉瘤。行DCE检查时,高度恶性原发性骨肉瘤病灶TIC类型多为Ⅰ型,而低度恶性原发性骨肉瘤TIC类型多为Ⅲ型。
[Abstract]:Objective to compare the results of Mr diffusion weighted imaging (DWI), magnetic resonance spectrum imaging (MRS) and dynamic contrast enhanced scanning (DCEE) in patients with low and high malignant primary osteosarcoma, and to explore the characteristics of DWIMr Mr Mr Mr Side-DCE (DCE) in patients with low and high malignant primary osteosarcoma. Methods 41 patients with osteosarcoma were divided into low grade malignant group and high malignant group. The lesions were examined by DWI1H-MRSU DCE. DWI sequences were divided into 5 different diffusion-sensitive coefficient (DWI), which were 0.400800 ~ 1 000 ~ 1 000 s / m ~ (2), respectively. The corresponding apparent diffusion coefficient (ADC) images were obtained by post-processing. The ADC value was calculated by selecting the region of interest, and the ADC values of the lesions in the patients with primary malignant osteosarcoma were compared under different b values. The MRS spectra of 18 patients with osteosarcoma with stable MRS spectrum were analyzed. The Cho/Cr value was calculated. The Cho/Cr value of the lesions in the patients with high malignant primary osteosarcoma was lower than that in the patients with high malignant osteosarcoma. The Cho/Cr value was determined by the operating curve of the subjects. The best diagnostic limit for high malignant primary osteosarcoma. The time-signal intensity curve of DCE was drawn to compare the difference of TIC type in patients with low and high malignant primary osteosarcoma. 缁撴灉浣庡害鎭舵，

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