Q-Dixon脂肪定量技术对恶性肿瘤患者椎体转移瘤和血管瘤的鉴别价值  

The value of Q-Dixon fat quantification technique in differentiating vertebral metastases and hemangiomas in patients with malignant tumors

作　　者：姜九明 李健维 王昊 江岳娈 徐立斌 李蒙 张丽 Jiang Jiuming;Li Jianwei;Wang Hao;Jiang Yueluan;Xu Libin;Li Meng;Zhang Li(Department of Radiology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;MR Research Collaboration,Siemens Healthineers,Beijing 100102,China;Department of Orthopedic Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院影像诊断科,北京100021 [2]西门子医疗系统有限公司北京分公司,北京100102 [3]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院骨科,北京100021

出　　处：《中国医师进修杂志》2024年第10期881-887,共7页Chinese Journal of Postgraduates of Medicine

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.2020-10-27);希思科-君实肿瘤免疫治疗临床研究基金(Y-JS2019-017)。

摘　　要：目的探讨磁共振(MRI)Q-Dixon脂肪定量技术在恶性肿瘤患者椎体转移瘤与血管瘤中的鉴别诊断价值。方法回顾性分析2021年12月至2023年12月在国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院接受椎体MRI扫描的20例椎体转移瘤和8例椎体血管瘤患者的MRI图像,由两名放射科医生分别测量三个区域(病灶区域、同椎体正常区域和相邻椎体正常区域)的脂肪分数(FF)并进行一致性评价。采用独立样本t检验或Mann-Whitney U检验进行组间差异性检验,通过绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC)评估诊断效能。结果两名放射科医生在三个区域的FF测量值具有非常高的观察者间一致性。椎体转移瘤组病灶区域FF值低于椎体血管瘤组(13.8±11.5比56.5±22.1),差异有统计学意义(P<0.01)。两组正常椎体区域FF值比较差异无统计学意义(P>0.05);ROC曲线分析显示,FF鉴别椎体转移瘤和椎体血管瘤的AUC为0.931,特异度为90%,灵敏度为87.5%。结论基于Q-Dixon脂肪定量技术测得的FF能够准确地区分椎体血管瘤与椎体转移瘤,为椎体病变的诊断提供更精确的指导。Objective To explore the diagnostic value of magnetic resonance imaging(MRI)Q-Dixon fat quantification technique in differentiating vertebral metastases from hemangiomas in cancer patients.Methods A retrospective analysis was conducted on 20 patients with vertebral metastases and 8 with vertebral hemangiomas who underwent vertebral MRI scans at the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College from December 2021 to December 2023.Two radiologists independently measured the fat fractions(FF)in three areas(the lesion area,the normal area of the same vertebra,and the normal area of an adjacent vertebra)and evaluated the consistency of measurements.Group differences were tested using independent sample t-tests or Mann-Whitney U tests,and diagnostic performance was assessed by plotting the receiver operating characteristic(ROC)curve and calculating the area under the curve(AUC).Results There was very high inter-observer consistency in the FF measurements across the three regions.The FF in the lesion areas of vertebral metastases group was significantly lower than that in the vertebral hemangioma group(13.8±11.5 vs.56.5±22.1),there was statistical difference(P<0.01).There were no significant differences in the FF of normal vertebral areas between the two groups(P>0.05).ROC curve analysis showed that FF could differentiate vertebral metastases from hemangiomas with an AUC of 0.931,a specificity of 90%,and a sensitivity of 87.5%.Conclusions The FF measured by the Q-Dixon quantitative fat technique can accurately differentiate between vertebral hemangiomas and vertebral metastases,providing more precise guidance for the diagnosis of vertebral lesions.

关 键 词：磁共振成像 脂肪分数 椎体转移瘤 椎体血管瘤 

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