磁共振扩散加权成像在肌肉骨骼良恶性病变鉴别诊断中的价值  

The application of DWI in differentiating benign musculoskeletal masses from malignant ones

作　　者：曹金凤 肖连祥[2] 袁蕾蕾[3] 何兵[1] 赵慧[2] 董金叶[2] 吴勇[2] 王光彬[2] 林祥涛[2] 

机构地区：[1]山东省淄博市中心医院,山东淄博255000 [2]山东大学附属山东省医学影像学研究所,山东济南250021 [3]山东省泰安市中心医院,山东泰安271000

出　　处：《医学影像学杂志》2015年第7期1261-1264,共4页Journal of Medical Imaging

摘　　要：目的探讨磁共振扩散加权成像(DWI)在鉴别肌肉骨骼良恶性病变诊断中的应用价值。方法对65例肌骨系统病变患者(良性组23例,恶性组42例)行MRI常规T1加权成像、T2加权成像、抑脂T2加权成像及DWI检查,测量并分析两组病变间ADC值差异,采用接受者操作特征曲线判定良恶性鉴别诊断阈值,并计算ADC值对病变潜在恶性评估的敏感度、特异度、准确度。统计学分析均使用统计软件SPSS 19.0完成。结果165例患者中,良性病变组平均ADC值为(1.83±0.50)×10-3 mm2/s,恶性病变组平均ADC值为(1.04±0.36)×10-3 mm2/s,两组间有显著性统计学差异(P<0.05);2以1.38×10-3 mm2/s为阈值,ADC值对肌骨病变潜在恶性评估的敏感度、特异度、准确度分别为95.24%、95.65%、95.38%。结论 DWI可以较好地反映病变的弥散特征,ADC值作为量化指标对肌骨病变良恶性的鉴别诊断有一定的价值。Objective To assess the diagnostic potential of DWI in differentiating benign from malignant musculoskeletal masses. Methods Routine MR examination and DWI was performed on 65 patients with musculoskeletal diseases （23 cases of benign and 42 cases of malignant） using siemens sonata 1.5 T MR scanner. All the patients were divided into benign and malignant group by pathology. ADC value was measured on DWI and receiver operating characteristic （ROC） curve was used to select the cut-off value to calculate the sensitivity, specificity and accuracy. Statistical analysis was completed by using SPSS19. 0. Results O In65cases, themeanADCvalueswere（1.83±0.50）×10-3mm2/s, （1.04±0.36）×10-3mm2/s for benign and malignant lesions, respectively. The difference was significant （ P 〈0.05）; （2） Using 1.38 ×10-3mm2/s as the cut-off value, the diagnostic sensitivity, specificity, and accuracy were 95.24%, 95.65%, 95.38%, respectively. Conclusion DWI can depict tissue diffusion characteristics. ADC value was valuable in the differential diagno- sis of benign and malignant museuloskeletal lesions.

关 键 词：肌肉骨骼病变 磁共振成像 扩散加权成像 

分 类 号：R681[医药卫生—骨科学] R685[医药卫生—外科学]