高场MRN诊断原发性周围神经肿瘤的应用研究  

The Application of 3. 0 T MRN in Diagnosing the Primary Tumor of Spinal Nerves

作　　者：龙茜[1] 柳曦[1] 孔祥泉[1] 李勇[1] 杨帆[1] 刘小明[1] 刘定西[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《临床放射学杂志》2013年第12期1752-1757,共6页Journal of Clinical Radiology

摘　　要：目的探讨3.0 T超高场磁共振神经成像(MRN)对原发性周围神经肿瘤诊断的准确性及临床应用价值。方法搜集2011年6月至2012年6月经病理证实的52例原发性周围神经肿瘤患者的MR资料,所有患者均行常规MRI平扫及结合短T1反转恢复时间成像(3D-STIR)增强序列扫描。回顾性分析和评价3D-STIR增强扫描序列对原发性周围神经肿瘤诊断的可行性及准确性,比较常规MRI平扫及3D-STIR增强序列扫描对原发性周围神经肿瘤诊断的定位、定性的准确性和特异性。结果 52例患者中,神经鞘瘤32例,神经纤维瘤16例,神经纤维瘤病4例。所有患者的3D-STIR增强扫描序列像上均可清晰显示周围神经走行及病变同周围神经相关性,其中定位诊断准确率为100%,定性诊断准确率90.4%,特异性95.2%。3D-STIR增强序列同手术组定性结果一致性较好(Kappa=0.819)且明显优于常规MRI平扫。结论 3D-STIR增强扫描序列对原发性周围神经肿瘤病变的定位和定性诊断有重要的临床应用价值,值得推广。Objective To investigate the accuracy of MRN （magnetic resonance neurography） in diagnosing primary tumors of spinal nerves and its clinic value. Methods Fifty two patients with spinal nerve primary tumors confirmed by surgery underwent MR examination during 2011.6 to 2012.6. The clinical data and MRN features were retrospectively ana- lyzed. According to surgery findings, the accuracy and specificity of conventional MR and enhanced 3D-STIR sequence MR scanning in diagnosing primary tumors of spinal nerves were calculated and compared. Results In these 52 cases, there were 32 cases of schwannoma, 16 cases of neurofibroma and 4 cases of neurofibromatosis. The course, continuity, shape and signal of the spinal nerves, the relevance between lesion and spinal nerves were clearly displayed on enhanced 3D-STIR sequence images. The accuracy of localization was 100% and the accuracy of diagnosis was 90.4% , the specificity was 95.2% , the consistence of diagnosis between the 3 D-STIR and surgery findings was good （Kappa = 0.819 ） and much better than the conventional MRI. Conclusion The enhanced 3D-STIR sequence represents a valuable and improved method for the diagnosis of spinal nervestumors.

关 键 词：磁共振成像 磁共振神经成像 原发性周围神经肿瘤 定性诊断 定位诊断 

分 类 号：R739.4[医药卫生—肿瘤]