磁共振弥散加权成像在脊柱转移瘤和脊柱感染性病变鉴别诊断中的应用  

The Application of Magnetic Resonance Diffusion Weighted Imaging in the Differential Diagnosis Spinal Metastatic Tumor and Spinal Infective Lesions

作　　者：李光纪[1] 陈首名[1] 罗鹰[1] 马方伟[1] 何志兵[1] LI Guangji, CHEN Shouming,LUO Ying,et al.(Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine ,Pan- zhihua , 61700)

机构地区：[1]四川省攀枝花市中西医结合医院,617000

出　　处：《实用癌症杂志》2018年第4期647-650,共4页The Practical Journal of Cancer

摘　　要：目的比较脊柱转移瘤和感染性病变的磁共振弥散加权成像(DWI)与表观扩散系数(ADC)值的不同特点,为二者鉴别诊断提供参考。方法选取30例脊柱转移瘤患者和24例脊柱感染患者为观察对象,分别为脊柱转移瘤组和脊柱感染组,2组患者均进行磁共振弥散加权成像检查。比较脊柱转移瘤病变和感染病变的磁共振弥散加权成像(DWI)、表观扩散系数(ADC)值以及对比噪声比(CNR)。结果 30例脊柱转移瘤组患者的弥散加权图像中,全部为高信号。24例脊柱感染疾病组患者的弥散加权图像中,18例患者为低信号,4例为等信号,2例患者为高信号。以DWI高信号作为脊柱转移瘤的诊断指标,诊断的敏感性为100.0%(30/30),特异性为91.67%(22/24),准确性为96.30%(52/54)。以DWI低信号作为脊柱感染病变的诊断指标,诊断的敏感性为75.05%(18/24),特异性为0.0%(0/30),准确性为33.33%(18/54)。脊柱转移瘤组患者病灶平均ADC值为(0.72±0.12)×10^(-3)mm^2/s,明显低于脊柱感染组患者的(1.43±0.14)×10^(-3)mm^2/s,比较差异有统计学意义(t=20.06,P<0.05)。脊柱转移瘤组患者病灶平均CNR值为(27.46±4.35),明显高于脊柱感染组患者的(13.58±3.14),差异有统计学意义(t=13.12,P<0.05)。结论脊柱转移瘤患者磁共振弥散加权成像以高信号为主,而感染性疾病以低信号为主,而且脊柱感染性疾病的ADC值明显高于脊柱转移瘤病变。磁共振弥散加权成像检查对于脊柱转移瘤和感染性疾病的鉴别诊断具有重要意义。Objective To compare the different characteristics of magnetic resonance diffusion weighted imaging（DWI） and apparent diffusion coefficient（ADC） values of the spine metastatic tumor and infectious disease, to provide reference for the differential diagnosis. Methods 30 cases of patients with spinal metastatic tumor and 24 cases of spinal infection patients were selected as the observation objects, and were respectively for the spinal meta static tumor group and the spinal infection group, two groups of patients were performed magnetic resonance diffusion weighted imaging, then the different characteristics of magnetic resonance diffusion weighted imaging（DWI） ,the apparent diffusion coefficient（ADC） and the contrast to noise ratio（CNR） val- ues of the spine metastatic tumor and infectious disease were compared. Results The DWI of the 30 cases of patients with spinal metastases were all high signal, and that of 24 cases of patients with spinal infection, 18 cases of patients were the low signal ,4 ca- ses were equisignal, and 2 cases were high signal. With the DWI high signal as the diagnosis indicators of the spinal metastatic tumor, the sensitivity was 100.0% （30/30） , the specificity was 91.67% （ 22/24）, and the accuracy was 96.30% （52/54）. With the DWI low signal as thediagnosis indicators of the spinal infection, the sensitivity was 75.05% （ 18/24）, the specificity was 0.0% （0/30） ,and the accuracy was 33.33% （18/54）. The ADC values of the spinal metastases group was （0.72 ± 0. 12） × 10-3 mm2/s, which was significantly lower than that of thespinal infection group was （ 1.43 ± 0.14） × 10-3 mm2/s, the comparative difference was statistically significant （ t = 20.06, P 〈 0.05 ）. The CNR values of the spinal metastases group was 27.46± 4.35, which was significantly higher than that of the spinal infection group was 13.58±3.14, the comparative difference was statistically significant （t = 13.12 ,P 〈 0.05）. Conclusion The DWI of the spine metasta

关 键 词：脊柱转移瘤 脊柱感染 磁共振弥散加权成像 表观扩散系数 对比噪声比 

分 类 号：R730.4[医药卫生—肿瘤]