DWI在中央型软骨性肿瘤鉴别诊断中的价值  

The value of DWI in the differential diagnosis of central type cartilaginous tumors——a preliminary study

作　　者：李振辉[1] 马焕[1] 李鹍[1] 王洪波[1] 陶海波[1] 

机构地区：[1]昆明医科大学第三附属医院云南省肿瘤医院放射科,昆明650018

出　　处：《放射学实践》2018年第2期187-191,共5页Radiologic Practice

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金(2014FB062)

摘　　要：目的:探讨磁共振扩散加权成像(DWI)在良、恶性中央型软骨性肿瘤鉴别诊断中的应用价值。方法:收集云南省肿瘤医院2012年1月-2016年6月经病理证实的中央型软骨性肿瘤46例,其中内生软骨瘤13例,交界性病变(非典型性软骨肿瘤/软骨肉瘤Ⅰ级)11例,恶性病变(软骨肉瘤Ⅱ级、Ⅲ级)22例。所有患者均于术前行常规MRI及DWI检查,测量每组病变的平均ADC值(ADC_(mean))和最小ADC值(ADC_(min))并采用单因素方差分析进行3组间比较。采用两独立样本t检验比较低级别软骨性肿瘤(内生软骨瘤组、交界性组)与高级别软骨肉瘤(恶性组)的ADC_(mean)和ADC_(min)。结果:内生软骨瘤、交界性病变及恶性病变的ADC_(mean)分别为(1.933±0.545)、(2.046±0.659)、(2.218±0.964)×10^(-3) mm^2/s;ADC_(min)分别为(1.607±0.420)、(1.984±0.835)、(1.791±0.813)×10^(-3) mm^2/s,3组间的ADC_(mean)、ADC_(min)差异均无统计学意义(P均>0.05)。低级别软骨性肿瘤与高级别软骨肉瘤的ADC_(mean)分别为(1.969±0.622)、(2.218±0.964)×10^(-3) mm^2/s;ADC_(min)分别为(1.795±0.712)、(1.791±0.813)×10^(-3) mm^2/s,两组间的ADC_(mean)、ADC_(min)差异均无统计学意义(P均>0.05)。结论:DWI无法区分内生软骨瘤、交界性(非典型性软骨肿瘤/软骨肉瘤Ⅰ级)和恶性病变(软骨肉瘤Ⅱ级、Ⅲ级);也不能较好的鉴别低级别软骨性病变和高级别软骨肉瘤。Objective：To explore the value of the diffusion-weighted imaging （DWI） and apparent diffusion coefficient （ADC） in the differential diagnosis of benign and malignant central type carti laginous tumors. Methods： MRI findings of 46 patients with central type cartilaginous tumors con- firmed by pathology were analyzed,including enchondroma （n： 13）,intermediate cartilaginous tumors （atypical cartilaginous tumor/grade I chondrosarcoma, n= 11） and malignant lesions （chondrosarco ma grade Ⅱ and Ⅲ, n ： 22） according to the histopathological differentiation. These cartilaginous tumors were divided into high grade （chondrosarcoma grade Ⅱ/Ⅲ ） or low grade （enchondroma,atypi cal cartilage tumor/grade I chondrosarcoma） cartilage tumors according to the histopathological differentiation of the lesions. The differences of mean ADC （ADC ） and minimum ADC （ADCmin） were measured and compared among the three groups. Results：The ADC of enchondromas,intermediate cartilage tumors and malignant lesions were （1. 933±0. 545） × 10^-3,（2. 046±0. 659） × 10^-3 and （2.218±0. 964）×10^-3 mm^2/s respectively. The ADCmin of enchondromas, intermediate cartilage tumors and malignant lesions were （1. 607±0. 420）×10^-3,（1. 984±0. 835）×10^-3 and （1. 791±0. 813）×10^-3mm^2/s respectively. There was no significant difference in ADC and ADCmin among the three groups （F=0. 549 and 0. 794,P〉0.05）. The ADC of low grade and high grade tumors was （1. 969±0. 622）×10^-3,（2.218±0.964） ×10^-3mm^2/s respectively. The ADCmin of low grade and high grade tumors was （1. 795±0. 712） × 10^-3 and （1. 791±0. 813） × 10^-3 mm^2/s respectively.ADC and ADCmin values between the two groups had no significant difference （t=1.031 and 0. 018, P〉0.05）. Conelusion：DWI can not distinguish among enchondromas, intermediate cartilage tumors （atypical cartilage neoplasms/chondrosarcoma grade I） or malignant lesions （chondrosarcoma grade Ⅱ/Ⅲ）,also can

关 键 词：内生软骨瘤 软骨肉瘤 扩散加权成像 磁共振成像 诊断 鉴别 

分 类 号：R738.1[医药卫生—肿瘤] R445.2[医药卫生—临床医学]