动态增强MRI在椎体转移瘤早期诊断中的应用  

Dynamic contrast-enhanced MRI of vertebral metastatic tumors' early diagnosis

作　　者：王健[1] 杨军[1] 江源[1] 高永辉[1] 

机构地区：[1]信阳职业技术学院附属医院骨科,河南省信阳464000

出　　处：《中国基层医药》2007年第9期1479-1481,1587,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的通过研究椎体转移瘤动态MRI早期信号值变化的特点,探讨动态MRI对椎体良、恶性病变的早期鉴别诊断价值。方法对20例椎体转移瘤患者进行动态MRI检查,测量、计算瘤体信号值各参数,并绘制时间-信号强度曲线,与正常椎体比较,分析其早期变化的特点。结果椎体转移瘤的峰值、峰值后最低值、峰值斜率值、初始增强百分比和最大增强百分比分别为:(50.61±11.38)、(46.75±10.23)、(0.73±0.12)、(0.33±0.08)、(1.03±0.31),正常椎体分别为:(40.53±12.12)、(34.72±14.06)、(0.31±0.11)、(- 0.25±0.05)、(0.69±0.28),而且有10例正常椎体的初始增强百分比为负值,转移瘤为2例,以上比较差异均有统计学意义。时间信号强度曲线共有早期快速上升和快速下降而后是个平台期(A型)、持续上升(B型)、上升后进入平台期(C型)、上升期后即进入快速下降期(D型)四型,转移瘤分别为6、5、5、5例,正常椎体主要为C型,有15例。A、B型及具有早期快速下降的线型提示为转移瘤,C型提示为正常椎体。结论动态增强MRI可以定量显示椎体转移瘤早期信号值动态变化的特点,且与正常椎体有明显的区别,对椎体转移瘤早期临床诊断具有应用价值。Objective To discuss the diagnostic value of dynamic contrast-enhanced MRI in differentiating vertebral metastatic tumors from benign deseases after studying the early changes of signal, intensity. Methods Twenty patients were scanned by dynamic contrast-enhanced MRI. The parameters of signal intensity were measured and calculated,and time-intensity cures（TICs） were drawn. Then,they were compared with those of normal vertebraes,the characteristics were analyzed. Results The parameters of vertebral metastatic minors：peak signal intensity, signal intensity minimum signal intensity of postpeak, peak slope, initial ratio of enhancement, maximum rano of enhancement was respectively （50.61 ±11.38）, （46.75 ± 10.23 ）, （0.73 ± 0.12）, （0.33 ± 0.08）, （1.03 ± 0, 31 ） ; that of normal vertebraes was respectively （40.53 ± 12.12 ）, （34.72 ± 14.06 ）, （0.31 ±0.11 ）, （ - 0.25 ±0.05）, （0.69 ± 0.28）;and ten normal eases showed negative in initial percent of enhancement, but only two abnormal vertebraes showed that. All of the above had significant statistical difference. Four types of TICs were concluded： early rapid rise and early rapid descent followed by steady phase（type A）, persistently rise（type B）, rise phase followed by steady phase（type C）, rise phase followed by rapid descent phase（type D）. TICs of abnormal vertebraes were respec- tively 6,5,5,5 cases; types of normal vertebraes were mainly type C, 15 cases. Type A and type B and the type with the characteristic of early rapid descent phase were features of abnormal vertebraes; type C was the feature of normal ones. Conclusions Dynamic contrast-enhanced MRI could quantitatively show the characteristics of early changes of Signal intensity of vertebral metastatic tumors, which were significant statistically different from those of normal vertebraes. Dynamic contrast-enhanced MRI was worth performing in the early diagnosis of vertebral metastatic tumors.

关 键 词：肿瘤 椎体 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤]