ADC直方图在椎体压缩性骨折时间判定中的应用  

The application of ADC histogram in determination the time of vertebral compression fracture

作　　者：徐良洲[1] 黄波[1] 程晓光[2] 程克斌[2] 张鑫 刘华 汪鹏[1] 刘坚[1] 蔡青蓉[1] XU Liang-zhou;HUANG Bo;CHENG Xiao-guang(Department of Radiology,Wuhan Hospital of Traditional Chinese Medicine,Wuhan 430014)

机构地区：[1]武汉市中医医院放射科,武汉430014 [2]北京积水潭医院放射科 [3]北京市公安司法鉴定中心

出　　处：《放射学实践》2018年第10期1048-1051,共4页Radiologic Practice

基　　金：北京市委;市政府重点工作及区县政府应急项目预启动计划课题(No.Z121100000312015);武汉市卫生和计划生育委员会科研项目(No.WZ16Z04)

摘　　要：目的:探讨表观扩散系数(ADC)直方图在椎体压缩性骨折时间判断中的可行性。方法:搜集42例胸腰椎压缩性骨折病例,在30d和90d时行磁共振扩散加权成像(DWI),在AW4.6上后处理得到ADC图,计算基于感兴趣区(ROI)的平均ADC值,对骨折整体进行ADC直方图分析,计算ADC值直方图的平均值、中位数、标准差、峰度值和偏度值。采用t检验比较30d和90d时的各参数之间是否存在差异,并利用受试者特性曲线(ROC曲线)评价存在统计差异的参数诊断效能。结果:骨折30d时,基于ROI的ADC平均值,直方图ADC平均值以及中位数分别为(1.14±0.34)×10-3 mm2/s、(1.22±0.38)×10-3 mm2/s及(0.97±0.26)×10-3 mm2/s,而骨折90d时,上述参数分别为(0.81±0.44)×10-3 mm2/s、(0.75±0.42)×10-3 mm2/s及(0.72±0.34)×10-3 mm2/s。90d时的上述参数均低于30d时的参数,有显著统计学差异(P<0.05),其ADC值分别为0.811、0.902和0.870。结论:直方图ADC平均值能鉴别新鲜骨折及陈旧骨折,为临床确定骨折时间提供了一定的依据。Objective:To investigate the feasibility of the apparent diffusion coefficient(ADC)histogram in determination the time of vertebral compression fractures.Methods:42 patients with thoracolumbar vertebral compression fractures were included.Diffusion-weighted imaging(DWI)was performed at 30 days and 90 days.ADC maps were obtained after post-processing on AW4.6 and ADC values were calculated based on regions of interest(ROI).The ADC histogram analysis for whole fractures were calculated,and the ADC value histograms for the mean,median,standard deviation,kurtosis,and skewness values were calculated.The t-test was used to compare the differences between the 30-day and 90-day parameters and the ROC curve analysis was used to evaluate the diagnostic efficacy of the parameters with statistical differences.Results:At 90 days of fracture,the mean value of ADC based on ROI,mean and median values of histogram ADC were higher than those at 30 days,there was significant statistical difference(P<0.05),and their AUC values were 0.811,0.902,and 0.870,respectively.Conclusions:The mean value of histogram ADC can identify fresh and old fractures,providing a certain basis for the clinical determination of fracture time.

关 键 词：胸椎 腰椎 骨折 压缩性 磁共振成像 

分 类 号：R323.4[医药卫生—人体解剖和组织胚胎学] R683[医药卫生—基础医学]