磁敏感加权成像鉴别良恶性软组织肿瘤的价值及其与病理对照分析  

Study of susceptibility weighted imaging on MR and pathologic findings to distinguish benign or malignant soft tissue tumor

作　　者：刘杰[1] 陈勇[1] 包雪梅[1] 凌小莉[1] 丁建平[1] 张泽坤[2] 

机构地区：[1]杭州师范大学附属医院放射科,310015 [2]河北医科大学第三医院CT室,石家庄050051

出　　处：《中华肿瘤杂志》2017年第5期350-354,共5页Chinese Journal of Oncology

基　　金：杭州市卫生科技计划一般A类项目（2014A17）

摘　　要：目的探讨磁敏感加权成像（SWI）鉴别良恶性软组织肿瘤的价值，并与病理进行对照研究。方法68例首诊、未行任何治疗及有创性检查的软组织肿瘤患者行常规磁共振成像（MRI）和SWI扫描，观察肿瘤内部磁敏感信号强度（ITSS）分级、分布及所占肿瘤体积比例，并结合病理结果进行对照分析。结果68例肿瘤患者中，良性40例，恶性28例。良性软组织肿瘤患者以ITSS 1级和ITSS 3级（均为血管瘤）为主，占72.5%（29/40）；恶性软组织肿瘤患者以ITSS 2级和ITSS 3级为主，占89.3%（25/28），差异有统计学意义（P〈0.01）。良性软组织肿瘤患者的ITSS分布以外周分布和弥漫性分布（均为血管瘤）为主，占90.0%（36/40）；恶性软组织肿瘤患者的ITSS分布以中央分布为主，占78.6%（22/28），差异有统计学意义（P〈0.01）。良性软组织肿瘤患者ITSS所占肿瘤体积比例以〈1/3和〉2/3（均为血管瘤）为主，占90.0%（36/40）；恶性软组织肿瘤以〈1/3为主，占82.1%（23/28），差异有统计学意义（P〈0.01）。结论SWI对软组织病变内静脉及血液代谢物的显示敏感，有助于良恶性软组织肿瘤的鉴别诊断。ObjectiveTo explore the diagnostic performance of susceptibility weighted imaging （SWI）in distinguishing benign or malignant soft tissue tumor, and to study pathological observation.MethodsSixty-eight patients with soft tissue tumor, who received no previous treatment or invasive examination, received routine preoperative MRI examination and SWI scanning. The graduation and distribution of intratumoral susceptibility signal intensity（ITSS） and proportion of tumor volume were observed.The pathological results were also included for comparative analysis.ResultsFourty of 68 patients were benign and 28 were malignant. 72.5% （29/40） patients with benign soft tissue tumors were ITSS grade 1 and ITSS grade 3 （hemangioma）. 89.3%（25/28） patients with malignant soft tissue tumors were ITSS grade 2 and ITSS grade 3. The difference was statistically significant （P〈0.01）. The distribution of ITSS in patients with benign soft tissue tumors was dominated by peripheral distribution and diffuse distribution （hemangioma）, accounting for 90.0% （36/40）. The distribution of ITSS in patients with malignant soft tissue tumors mainly distributed in the central region, accounting for 78.6% （22 /28）. The difference was statistically significant （P〈0.01）. The proportion of tumor volume occupied by ITSS in benign soft tissue tumors was 〈1/3 and〉 2/3 （hemangioma）, accounting for 90.0% （36/40）. The volume of malignant soft tissue tumors were predominantly 〈1/3 , accounting for 82.1% （23/28）. The difference was statistically significant （P〈0.01）.ConclusionSWI is sensitive in displaying the vein and blood metabolites in soft tissue lesions, which is helpful for the differential diagnosis of benign and malignant tumors in soft tissue.

关 键 词：磁敏感加权成像 肿瘤 软组织 鉴别诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R738.6[医药卫生—诊断学]