表观扩散系数值在上腹部扩散加权成像检查中鉴别椎体良恶性病变的价值  

The role of apparent diffusion coefficient in the differentiation between benign andmalignant vertebral tumors in upper abdominal diffusion weighted imaging examination

作　　者：孙春锋[1] 陆健[1] 张沛枫[1] 缪小芬[1] 姜吉锋[1] 王绍刚[1] 

机构地区：[1]南通大学附属南通第三医院影像科,江苏南通226000

出　　处：《实用放射学杂志》2013年第10期1632-1636,共5页Journal of Practical Radiology

摘　　要：探讨表观扩散系数（ADC）值在上腹部扩散加权成像（DWI）中鉴别椎体良恶性病变的价值。方法 收集行上腹部DWI检查且符合入组条件的椎体HCC转移瘤33例、椎体血管瘤32例及正常椎体30例。所有感兴趣区（ROI）均测量3次取ADC平均值。组间比较行成组设计方差分析;利用ROC曲线得到判断椎体良恶性病变的ADC值阈值,获得诊断椎体恶性病变的敏感度、特异度、阳性预测值、阴性预测值及准确性。以P〈0.05为差异有统计学意义。结果 正常椎体组、椎体血管瘤组及椎体HCC转移瘤组ADC值分别为（0.76±0.32）×10-3 mm2/s、（1.40±0.37）×10-3 mm2/s、（1.11±0.39）×10-3 mm2/s;3组ADC值两两比较均有显著统计学意义（P〈0.01）。以ADC值≤1.25×10-3 mm2/s为诊断恶性（椎体HCC转移瘤）阈值时,其敏感度、特异度、阳性预测值、阴性预测值和准确性分别为73.7%、76.0%、82.35%、65.52%、81.03%。结论 椎体良恶性病变的ADC值均高于正常椎体;椎体血管瘤的ADC值高于椎体HCC转移瘤,以ADC值≤1.25×10-3 mm2/s为诊断阈值,对鉴别椎体良恶性病变有一定价值。Objective To investigate the value of the apparent diffusion coefficient （ADC） in the differentiation between benign and malignant vertebral tumors in upper abdominal diffusion weighted imaging （DWI） examination. Methods All the data that were taken upper abdominal DWI examination and met the entry conditions were collected, including 33 cases of vertebral HCC metastasis, 32 cases of vertebral hemangioma and 30 cases of normal vertebral body. All ADC value of regions of interest （ ROI ） were measured three times and calculated to obtain average-value. Group design variance analysis was used in comparison between groups; the threshold ADC value of the differentiation between benign and malignant vertebral tumors was obtained by ROC curve, and the sensitivity, specificity, positive predictive value（PPV）, negative predictive value（NPV） and accuracy of the diagnosis of vertebral malignant lesions were analysed. The difference was statistically significant as P〈0.05. Results In the group of normal vertebra, group of vertebral hemangioma, and group of vertebral HCC metastases, ADC values were （0.76±0.32） ×10-3mm2/s, （ 1.40±0.37） ×10-3 mm2/s, and （ 1.11± 0.39） ×10-3 mm2/s, respectively. There were significant differences among the three groups （P 〈0.01）. Using ADC value as 1.25×10-3 mm2/s was used for the diagnosis of malignant （ vertebral HCC metastases） threshold, the sensitivity, specificity, PPV, NPV and accuracy were 73.71%, 76.00%, 82.35%, 65.52% and 81.03%, respectively. Conclu- sion Both the ADC values of vertebral benign and malignant lesions are higher than that of normal vertebra; the ADC value of ver- tebral hemangioma is higher than that of vertebral HCC metastases. The ADCthreshold value as 1.25×10-3mm2/s has some cer rain wdue for DWI in distinguishing the benign and malignant vertebral tumors.

关 键 词：扩散加权成像 磁共振成像 肝细胞癌 血管瘤 转移瘤 椎体 

分 类 号：R445.2[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]