摘要
目的分析动态增强磁共振(DCE-MRI)定量参数对下肢良恶性肌肉骨骼系统肿瘤(肌骨肿瘤)的鉴别诊断价值。方法回顾性分析我院行手术治疗的69例下肢肌骨肿瘤患者临床资料,根据其良恶性情况分为良性组(n=26例)及恶性组(n=43)。分析下肢良恶性肌骨肿瘤手术病理检查结果,比较两组术前DCE-MRI定量参数[容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外容积分数(Ve)]及时间-信号曲线(TIC)图像差异,并记录DCEMRI诊断良恶性下肢肌骨肿瘤的诊断价值。结果 26例良性患者中非骨化性纤维瘤6例,肌间血管瘤5例,脂肪瘤4例,动脉瘤样骨囊肿、弥漫性腱鞘巨细胞瘤、神经鞘瘤各3例,软骨母细胞瘤、血管平滑肌瘤各1例;43例恶性患者中骨肉瘤26例,软骨肉瘤6例,脊索瘤5例,高分化脂肪肉瘤4,高分化纤维肉瘤、平滑肌肉瘤各1例。两组Ve水平比较,差异无统计学意义(P>0.05);良性组Ktrans、Kep水平明显低于恶性组(P<0.05)。两组TIC图像类型比较,差异有统计学意义(P<0.05)。DCE-MRI对良恶性下肢肌骨肿瘤诊断准确64例(92.75%),Kappa值为0.847(P<0.001),一致性极强。结论 DCE-MRI诊断良恶性下肢肌骨肿瘤效果较好,其Ktrans、Kep等定量参数及TIC图像均具有较高的诊断价值。
Objective To analyze the differential diagnosis value of dynamic contrastenhanced magnetic resonance imaging(DCE-MRI) quantitative parameters in benign and malignant lower extremity musculoskeletal tumors. Methods The clinical data of 69 patients with lower extremity musculoskeletal tumors treated with surgery in our hospital were retrospectively analyzed. According to the benign and malignant conditions, they were divided into benign group(n=26) and malignant group(n=43). The results of surgical pathological examination of benign and malignant musculoskeletal tumors were analyzed. The preoperative DCE-MRI quantitative parameters [capacity transfer constant(Ktrans), rate constant(Kep), extravascular extracellular volume fraction(Ve)] and time-intensity curve(TIC) images were compared between the two groups. And the diagnostic value of DCE-MRI in the diagnosis of benign and malignant lower extremity musculoskeletal tumors was recorded. Results Among the 26 benign patients, there were 6 cases of non-ossifying fibroma, 5 cases of intermuscular hemangioma, 4 cases of lipoma, 3 cases of aneurysmal bone cyst, 3 cases of diffuse-type tenosynovial giant cell tumor, 3 cases of schwannomas, 1 case of chondroblastoma and 1 case of angioleiomyoma. Among 40 malignant patients, there were 26 cases of osteosarcoma, 6 cases of chondrosarcoma, 5 cases of chordoma, 4 cases of highly-differentiated liposarcoma, 1 case of highly-differentiated fibrosarcoma and 1 case of leiomyosarcoma. There was no significant difference in the level of Ve between the two groups(P>0.05). The levels of Ktrans and Kep in benign group were significantly lower than those in malignant group(P<0.05). There were significant differences in the types of TIC images between the two groups(P<0.05). 64 cases(92.75%) of benign and malignant lower extremity musculoskeletal tumors were accurately diagnosed by DCE-MRI, and Kappa value was 0.847, and the consistency was extremely strong(P<0.001). Conclusion DCE-MRI has good effect in the diagnosis of benign and malignant lower extremity musculoskeletal tumors. The quantitative parameters Ktrans and Kep and TIC images have high diagnostic value.
作者
蒋敏
李愉
JINAG Min;LI Yu(Department of Radiology,Gansu Provincial People's Hospital,Lanzhou 730000,Gansu Province,China)
出处
《中国CT和MRI杂志》
2020年第2期125-127,共3页
Chinese Journal of CT and MRI
基金
甘肃省自然科学基金资助课题(1606RJ2A107)。
关键词
DCE-MRI
定量参数
肌骨肿瘤
下肢
良性
恶性
DCE-MRI
Quantitative Parameters
Musculoskeletal Tumors
Lower Extremity
Benign
Malignant
