兔VX2恶性骨肿瘤浸润范围的DWI与病理对照研究  

Comparative study of diffusion-weighted imaging and pathology of VX2 malignant bone tumor in rabbits

作　　者：吴增杰[1] 董诚[1] 边甜甜[2] 庞婧[1] 李晓丽[1] 郭佳 孙伟凯 郝大鹏[1] 陈海松[1] 徐文坚[1] WU Zeng-jie;DONG Cheng;BIAN Tian-tian(Department of Radiology,the Affiliated Hospital of Qingdao University,Qingdao 266005,China)

机构地区：[1]青岛大学附属医院放射科,山东266000 [2]青岛大学附属医院乳腺病诊疗中心,山东266000

出　　处：《放射学实践》2021年第1期37-41,共5页Radiologic Practice

摘　　要：目的:探讨PROPELLER序列扩散加权成像(DWI)对显示恶性骨肿瘤浸润范围的价值。方法:建立30只兔右侧胫骨恶性骨肿瘤模型,并行MRI常规序列及DWI(b=500 s/mm^2)检查。DWI图像上测量肿瘤实性区、肿瘤坏死区、肌肉水肿、正常肌肉、骨髓水肿的平均表观扩散系数(ADC)值;于矢状位肿瘤最大层面分别测量DWI-ADC、快速自旋回波(FSE)T 2WI、脂肪抑制(FS)FSE-T 2WI、短时反转恢复序列(STIR)图像以及病理标本中的肿瘤浸润范围(肿瘤最大横径与最大纵径之和),并对DWI图像与病理结果进行对照研究。采用单因素方差分析和配对t检验比较MRI各序列与病理切片显示肿瘤浸润范围的差异。计算ADC图像显示肿瘤浸润范围的敏感度及特异度。结果:肿瘤实性区、肿瘤坏死区、瘤周肌肉水肿近端、肌肉水肿远端、正常肌肉、骨髓水肿的平均ADC值分别为1.16×10^-3、1.81×10^-3、2.20×10^-3、2.33×10^-3、1.86×10^-3、1.88×10^-3 mm^2/s,不同组织区域的ADC值差异有统计学意义(F=1146.78,P<0.001);除正常肌肉与骨髓水肿的ADC值差异无统计学意义(P=0.939)外,其他不同病变区域的ADC值两两比较差异均有统计学意义(P<0.05)。经与病理切片对照,肌肉水肿近端区内见肿瘤细胞浸润,肌肉水肿远端区、骨髓水肿区、正常肌肉区均无肿瘤细胞浸润。ADC图、FSE-T 2WI、T 2WI+FS、STIR及病理大切片的肿瘤浸润范围测量值分别为(5.30±0.89)、(5.52±0.87)、(5.42±0.87)、(5.43±0.85)和(5.20±0.89)cm,各方法测量的肿瘤浸润范围差异无统计学意义。DWI-ADC图、FSE-T2WI、T2WI+FS、STIR对显示肿瘤浸润范围的敏感度分别为93.3%、53.3%、66.7%、60.0%,特异度分别为80.0%、33.3%、53.3%、40.0%。结论:DWI-ADC图可通过ADC值定量区分不同组织成分,准确客观地确定肿瘤浸润范围,且显示肿瘤范围的敏感度及特异度最高,较常规序列更有优势。Objective:The purpose of this study was to analyze the manifestations of diffusion-weighted imaging(DWI)of PROPRLLER sequence and to explore its value in displaying the invasive range of malignant bone tumor in rabits.Methods:VX2 carcinomas were implanted into the tibia of 30 rabbits.MRI examinations,with sequences including sagittal PROPELLER DWI(b=500s/mm^2),FSE T 2WI,FS FSE T 2WI and STIR,were performed.Then histological examinations and MRI-pathologic correlation experiments were carried out.The mean ADC values,sensitivity and specificity were calculated.The regions of interest(ROI)contained viable tumor,tumor necrosis,peritumoral edema and normal muscle tissue.The range of the bone tumor was measured separately by MRI and histological methods and analyzed statistically.Results:The mean ADC of viable tumor,tumor necrosis,nearby muscle edema,distant muscle edema,normal muscle tissue and bone marrow edema were 1.16×10^-3 mm^2,1.81×10^-3 mm^2/s,2.20×10^-3 mm^2/s,2.33×10^-3 mm^2/s,1.86×10^-3 mm^2/s and 1.88×10^-3 mm^2/s,respectively.The above ADC values of ROI were all different from each other significantly(F=1146.78,P<0.001).The mean tumor size measured in T2WI,FSE T2WI+FS,STIR,ADC and the pathological section were(5.52±0.87)cm,(5.42±0.87)cm,(5.43±0.85)cm,(5.20±0.89)cm and(5.30±0.89)cm.There was no significantly difference among various MRI sequences and the pathological section.The sensitivity and specificity of different MRI sequences(T 2WI,FSE T 2WI+FS,STIR,PROPPLER DWI-ADC)for displaying the tumor margin were(53.3%,33.3%),(66.7%,53.3%),(60.0%,40.0%)and(93.3%,80.0%).Conclusion:DWI-ADC map can quantitatively distinguish different tissue compositions by ADC measurements,thus it can accurately and objectively determine the invasion scope of malignant bone tumor.Moreover,the sensitivity and specificity of DWI are better,than those of conventional sequences.

关 键 词：兔 恶性骨肿瘤 VX2细胞株 磁共振成像 扩散加权成像 肿瘤浸润范围 ADC值 

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