扩散峰度成像和扩散加权成像在鉴别良性、中间型及恶性软组织肿瘤中的价值  

Value of Diffusion Kurtosis Imaging and Diffusion Weighted Imaging in the Differentiation of Benign,Intermediate,and Malignant Soft Tissue Tumors

作　　者：张凯 戴越 刘亚洁[1] 段志青 王绍武[1] ZHANG Kai;DAI Yue;LIU Yajie(Department of Radiology,The Second Hospital,Dalian Medical University,Dalian,Liaoning Province,116023,P.R.China)

机构地区：[1]大连医科大学附属第二医院放射科,116023 [2]大连市中心医院放射科,116023

出　　处：《临床放射学杂志》2022年第10期1935-1940,共6页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:81771804)。

摘　　要：目的 探讨扩散峰度成像(DKI)和扩散加权成像(DWI)在鉴别良性、中间型及恶性软组织肿瘤(STT)中的价值.方法 前瞻性搜集经术后病理证实的STT患者58例,共60个病灶,其中良性14例、中间型10例,恶性36例,在术前均行常规MRI、DWI及DKI检查.利用后处理软件测得表观扩散系数(ADC)值、平均扩散峰度(MK)值、平均扩散系数(MD)值及各向异性分数(FA)值.采用单因素方差分析比较三组间各参数的差异,以LSD法进行事后多重检验.通过受试者工作特征(ROC)曲线分析各参数的诊断效能及最佳诊断阈值.结果 良性、中间型及恶性STT三组间ADC﹑MK及MD值差异有统计学意义(P<0.05),FA值差异无统计学意义(P>0.05).恶性肿瘤组的ADC、MD值显著低于良性肿瘤组(P<0.001),MK值显著高于良性肿瘤组和中间型肿瘤组(P<0.001,P=0.003).中间型肿瘤组的MD值显著低于良性肿瘤组(P=0.035),并且显著高于恶性肿瘤组(P=0.006).MD值鉴别良性和中间型肿瘤的曲线下面积(AUC)为0.807.MK、MD值鉴别中间型和恶性肿瘤的AUC分别为0.821﹑0.775.ADC、MK及MD值鉴别良性和恶性肿瘤的AUC分别为0.806﹑0.851﹑0.911,MD值的诊断特异度和准确率最高,分别为91.7%、88.0%.结论 DWI和DKI有助于STT的术前定性诊断,MD值的诊断价值最高.Objective To explore the value of diffusion kurtosis imaging and diffusion weighted imaging in the differentiation of benign,intermediate and malignant soft tissue tumors.Methods A total of 58 patients with soft tissue tumors confirmed by postoperative pathology were prospectively collected,with a total of 60 lesions,of which 14 were benign,10 were intermediate,and 36 were malignant.All patients underwent routine MRI,DWI and DKI examinations.Post-processing software was used to measure ADC,MK,MD and FA values.One-way analysis of variance was used to compare the differences of the parameters between the three groups,and the LSD method was used to perform post-hoc multiple testing.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy and the best diagnostic threshold of each parameter.Results The ADC,MK and MD values of benign,intermediate and malignant soft tissue tumors were statistically different(P<0.05),but the FA value was not statistically significant(P>0.05).The ADC and MD values of the malignant tumor group were significantly lower than those of the benign tumor group(P<0.001),and the MK value was significantly higher than that of the benign tumor group and the intermediate tumor group(P<0.001,P=0.003).The MD value of the intermediate tumor group was significantly lower than that of the benign tumor group(P=0.035),and significantly higher than that of the malignant tumor group(P=0.006).The area under the curve(AUC)for the MD value to distinguish benign and intermediate tumors was 0.807.The AUC of MK and MD values for distinguishing intermediate and malignant tumors were 0.821 and 0.775,respectively.The AUC of ADC,MK,and MD values for distinguishing benign and malignant tumors were 0.806,0.851,and 0.911,respectively.The MD value had the highest diagnostic specificity and accuracy,91.7%and 88.0%,respectively.Conclusion DWI and DKI are helpful for preoperative qualitative diagnosis of soft tissue tumors.MD value has the highest diagnostic value.

关 键 词：软组织肿瘤 磁共振成像 扩散加权成像 扩散峰度成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R738.6[医药卫生—诊断学]