摘要
目的结合常规MRI,探讨磁共振弥散加权成像对脊椎良恶性病变的鉴别诊断价值。方法选择64例脊椎良恶性病变患者为研究对象,应用1.5T磁共振扫描仪采集数据,包括常规T1WI、T2WI和DWI,DWI b值分别选择70 s/mm^2、100 s/mm^2、165 s/mm^2、300 s/mm^2、500 s/mm^2,经Functool 2软件分析处理得到病变部位的表观弥散系数(ADC)值和指数弥散系数(EDC)值。采用统计软件包(SPSS 13.0)对以上观察内容进行统计学分析。结果DWI中,脊椎良、恶性病变的信号差异无显著性。b≤100 s/mm^2时,弥散效应不明显;b>300 s/mm^2时,图像信-噪比过低。当b= 165 s/mm^2时,其图像可满足诊断需要。当b=165 s/mm^2时,脊椎良性病变的ADC值为(3.19±0.33)×10^(-4)mm^2/s,EDC值为(715.68±28.36)×10^(-3);脊椎恶性肿瘤(转移瘤)的ADC值为(1.87±0.12)×10^(-4)mm^2/s,EDC值为(1466.25±41.69)×10^(-3)。与恶性肿瘤相比,脊椎良性病变的ADC值明显偏高,EDC值明显偏低。结论脊椎良、恶性病变的DWI信号差异无显著性。因此,不能单纯根据DWI信号的高低对脊椎良、恶性病变进行鉴别诊断。脊椎EPI-DWI中,当b值在100～300 s/mm^2时,能够得到适合临床诊断需要的图像。当b=165 s/mm^2时,脊椎ADC值和EDC值可作为良恶性病变鉴别诊断的指标之一。若ADC值大、EDC值小,则提示病变良性可能较大;反之则提示恶性肿瘤可能。
Objective To evaluate the clinical application value of diffusion weighted imaging in differentiation of benign and malignant vertebral diseases. Methods Conventional MRI and DWI with b values as 70 s/mm^2 , 100 s/mm^2 , 165 s/mm^2 , 300 s/mm^2 and 500 s/mm^2 respectively were performed in 64 patients with vertebral disease. ADC and EDC values were obtained on delineated ROI by the Functool 2 software system. The data were analyzed with soft-ware （SPSS, version 13.0）. Results There was no significant difference of signal of DWI between benign and malignant vertebral diseases. The diffusion effects was not significant when b value was smaller than 100 s/mm^2. The signal noise ratio was so low when b value was larger than 300 s/mm^2. With b value as 165 s/mm^2 , the diffusion images were suitable for clinical diagnosis. When b value was 165 s/mm^2 , the ADCs of benign vertebral diseases were higher than those of malignant ones （[（3.19±0.33） vs （1.87 ±0.12）] ×10^-4 mm^2/s）, and EDCs of benign group were lower than those of malignant ones （[（715.68±28.36） vs （1466.25±41.69）] ×10^-3 ）. Conclusion The signal of DWI is not reliable to distinguish benign from malignant vertebral diseases, however, ADCs and EDCs of diffusion weighted imaging are helpful for differentiation.
出处
《中国医学影像技术》
CSCD
北大核心
2008年第10期1501-1504,共4页
Chinese Journal of Medical Imaging Technology
关键词
脊椎病变
弥散加权成像
磁共振成像
Vertebra
Diffusion weighted imaging
Magnetic resonance imaging
