快速对比增强MRI诊断良恶性软骨肿瘤的价值研究  

Study on Diagnostic Value of Fast Contrast Material-enhanced MRI between Benign and Malignant Cartilaginous Tumors

作　　者：初继栋 宋敏 宋善军 高维仁 

机构地区：[1]聊城市第三人民医院,山东聊城252000

出　　处：《实用医技杂志》2007年第12期1515-1517,共3页Journal of Practical Medical Techniques

摘　　要：目的:探讨利用快速对比增强MRI鉴别良恶性软骨肿瘤。方法:37例患者中,有8例内生软骨瘤,11例骨软骨瘤,18例软骨肉瘤。对其进行快速对比增强MRI扫描,按开始出现强化的时间不同分为:早期增强—动脉强化后10s内开始强化;进展期增强—动脉强化后10s～2min之间;延迟期增强—动脉强化5min后。结果显示与27例外科手术标本、3例刮除物标本和7例活检标本,结合长期随访结果和组织病例诊断相互关联。结果:强化的开端同良恶性肿瘤存在显著相关性(P<0.001)。早期增强可出现在软骨肉瘤病例中,亦出现在骺板未融合的骨软骨瘤病例中,但不出现在内生型软骨瘤中。诊断恶性软骨肿瘤的敏感度为89%,特异性为84%,阳性预测值为84%,阴性预测值为89%。结论:快速对比增强MRI成像有助于鉴别成人的良恶性软骨肿瘤。Objective To differentiate between benign and malignant cartilaginous tumors with fast contrast material-enhanced magnetic resonance（MR） imaging. Methods In 37patients, fast contrast-enhancedMR images were obtained in eight enchondromas, 11 osteoehondromas, and 18 chondrosarcomas. Start of enhancement-early, within 10seconds after arterial enhancement ; delayed enhancement, between 10 seconds and 2 minutes ; late, after 5 minuteson spin-echo images. Findings were correlated with the surgical specimen in 27 cases, curettage material in three cases, and biopsy sample in seven cases. Results Start of enhancement correlated significantly（ P 〈0. 001 ） with benign and malignant tumors. Early enhancement was seen in chondrosarcoma, not seen in enchondroma, and seen in osteochondroma only when growth plates were unfused. The sensitivity was 89% , specificity 84% , positive predictive value 84% , and negative predictive value 89%. Conclusion Preliminary results show that in the adult population fast contrast-enhanced MRI imaging may assist in differentiation between benign and malignant cartilaginous tumors.

关 键 词：快速对比增强 MRI 软骨肉瘤 骨软骨瘤 内生型软骨瘤 扰相GRE序列 软组织 

分 类 号：R738.3[医药卫生—肿瘤]