动态增强MRI对良恶性骨肿瘤的鉴别诊断价值研究  

Value Research of Dynamic-enhanced MRI in the Differential Diagnosis of Benign and Malignant Bone Tumors

作　　者：张函光[1] ZHANG Hanguang(Heilongjiang Jiamusi Maternal and Child Health Hospital,Jiamusi 154002,China)

机构地区：[1]黑龙江省佳木斯市妇幼保健院,黑龙江佳木斯154002

出　　处：《中国医学创新》2021年第7期167-170,共4页Medical Innovation of China

摘　　要：目的:探讨动态增强MRI对良恶性骨肿瘤的鉴别诊断价值。方法:选取2018年2月-2019年12月本院收治的67例骨肿瘤患者作为研究对象,按肿瘤性质分为良性组(n=31)和恶性组(n=36)。所有患者均在术前行动态增强MRI(DCE-MRI)检查,以术后病理检查结果作为金标准,计算DCE-MRI对骨肿瘤良恶性诊断准确度、灵敏度、特异度和Kappa值;比较两组DCE-MRI定量参数容量转运常数(K^(trans))、速率常数(K_(ep))、血管外细胞外容积分数(V_(e))和初始曲线下面积(iAUC);计算ROC曲线下面积与各定量参数指标对骨肿瘤良恶性诊断准确度、灵敏度、特异度和Kappa值。结果:DCE-MRI对骨肿瘤良恶诊断灵敏度、特异度、准确度和Kappa值分别为90.32%、94.44%、92.54%、0.85。良性组K^(trans)、K_(ep)、iAUC均明显低于恶性组(P<0.05);两组V_(e)水平比较,差异无统计学意义(P>0.05)。K^(trans)、K_(ep)、iAUC的最佳诊断切断点分别为1.245/min、3.325/min、21.69,ROC曲线下面积分别为0.823、0.855、0.769。K^(trans)对骨肿瘤良恶诊断灵敏度、特异度、准确度和Kappa值分别为93.55%、86.11%、89.55%、0.791;K_(ep)对骨肿瘤良恶诊断灵敏度、特异度、准确度和Kappa值分别为96.77%、83.33%、89.55%、0.792;iAUC对骨肿瘤良恶诊断灵敏度、特异度、准确度和Kappa值分别为90.32%、77.78%、83.58%、0.673。结论:DCE-MRI鉴别诊断骨肿瘤良恶性准确度高,一致性极强,K^(trans)、K_(ep)、iAUC等定量参数作为辅助诊断指标具有较高的诊断价值。Objective:To explore the value of dynamic-enhanced MRI in the differential diagnosis of benign and malignant bone tumors.Method:A total of 67 patients with bone tumor admitted to our hospital from February 2018 to December 2019 were selected as the research subjects,they were divided into benign group (n=31) and malignant group (n=36) according to tumor nature.All patients were examined with dynamic contrast-enhanced MRI (DCE-MRI) before operation,the results of postoperative pathological examination were taken as the gold standard,the accuracy,sensitivity,specificity and Kappa of DCE-MRI were calculated,the quantitative parameters of DCE-MRI for volume transport constant (K^(trans)),rate constant (K_(ep)),extracellular volume fraction (V_(e)) and area under initial curve (iAUC) were compared between the two groups.The area under the ROC curve and the diagnostic accuracy,sensitivity,specificity and Kappa value of various quantitative parameters for benign and malignant bone tumors were calculated.Result:The sensitivity,specificity,accuracy and Kappa values of DCE-MRI in benign and malignant bone tumors were 90.32%,94.44%,92.54% and 0.85,respectively.K^(trans),KEP and iAUC in benign group were significantly lower than those in malignant group (P<0.05),there was no significant difference in V_(e) level between the two groups (P>0.05).The optimal diagnostic cut-off points for K^(trans),K_(ep) and iAUC were 1.245/min,3.325/min and 21.69,respectively,the areas under the ROC curve were 0.823,0.855 and 0.769,respectively.The sensitivity,specificity,accuracy and Kappa values of K^(trans) for benign and malignant bone tumors were 93.55%,86.11%,89.55% and 0.791,respectively.The sensitivity,specificity,accuracy and Kappa values of K_(ep) for benign and malignant bone tumors were 96.77%,83.33%,89.55% and 0.792,respectively.The sensitivity,specificity,accuracy and Kappa values of iAUC for benign and malignant bone tumors were 90.32%,77.78%,83.58% and 0.673,respectively.Conclusion:DCE-MRI has a high accuracy and consistency in

关 键 词：动态增强MRI 骨肿瘤 良性 恶性 

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