本文選題：軟組織腫瘤　切入點(diǎn)：磁共振成像　出處：《臨床放射學(xué)雜志》2015年12期 　論文類型：期刊論文

【摘要】：目的探討動(dòng)態(tài)增強(qiáng)MRI鑒別良、惡性軟組織腫瘤的價(jià)值。方法前瞻性搜集經(jīng)手術(shù)病理證實(shí)的42例良、惡性軟組織腫瘤的MRI資料。所有病例均行MRI平掃、增強(qiáng)及動(dòng)態(tài)增強(qiáng)掃描,觀察分析MRI異常征象特征及時(shí)間-信號(hào)強(qiáng)度曲線(TIC)的形態(tài)特點(diǎn),計(jì)算最大強(qiáng)化率(ER_(max))和最大上升斜率(Slope_(max)),采用秩和檢驗(yàn)分析兩組間TIC及量化參數(shù)的差異,以病理結(jié)果為金標(biāo)準(zhǔn),用ROC曲線下面積評(píng)價(jià)各動(dòng)態(tài)參數(shù)的診斷效能。結(jié)果 17例惡性腫瘤動(dòng)態(tài)增強(qiáng)掃描的TIC,14例呈快速上升型,3例呈上升平臺(tái)型;25例良性腫瘤的TIC,4例呈快速上升型,13例呈上升平臺(tái)型,8例呈延遲上升型。兩組間的差異有高度統(tǒng)計(jì)學(xué)意義(Z值為4.229,P0.01)。惡性腫瘤ER_(max)為(458.43±351.40)%,Slope_(max)為(16.47±11.36)%/s。良性腫瘤ER_(max)為(284.64±265.35)%,Slope_(max)為(7.70±9.03)%/s。兩組間ER_(max)和Slope_(max)的差異有統(tǒng)計(jì)學(xué)意義(Z值分別為1.961、3.203,P0.05、P0.01)。ER_(max)、Slope_(max)和兩者聯(lián)合的ROC曲線下面積分別為0.680、0.794和0.793,以最大約登指數(shù)為切入值,ER_(max)為298.33%、Slope_(max)為5.945%/s時(shí),兩者鑒別良、惡性軟組織腫瘤的敏感性分別為58.82%和82.35%,特異性分別為76.00%和72.00%,兩者聯(lián)合應(yīng)用的敏感性為94.12%,特異性為60.00%。結(jié)論動(dòng)態(tài)增強(qiáng)MRI掃描的TIC及ER_(max)和Slope_(max)半量化指標(biāo)有助于良、惡性軟組織腫瘤的鑒別。
[Abstract]:Objective to investigate the dynamic enhanced MRI in differential diagnosis of benign and malignant soft tissue tumors value. Methods prospective pathologically confirmed 42 cases of benign and malignant soft tissue tumor MRI. All patients underwent MRI scan, enhanced and dynamic enhanced scanning, observation and analysis of abnormal MRI signs and the time signal intensity curve (TIC) morphological characteristics, the calculation of the maximum enhancement rate (ER_ (max)) and the maximum slope of increase (Slope_ (max)), the differences were analyzed using rank sum test and TIC quantitative parameters between the two groups, with pathological results as the gold standard to evaluate the performance of the dynamic parameters in the area under the ROC curve. The results of 17 cases malignant tumor of TIC dynamic contrast-enhanced scan, 14 cases showed a rapid rising type, 3 cases of upward platform type; 25 cases of benign tumor TIC, 4 cases of type 13 cases was rapidly rising, rising platform type, 8 cases showed delayed increase. The difference between the two groups was statistically significant (Z = 4. 229, P0.01). ER_ (max) for malignant tumors (458.43 + 351.40)%, Slope_ (max) is (16.47 + 11.36)%/s. ER_ (max) for benign tumors (284.64 + 265.35)%, Slope_ (max) is (7.70 + 9.03)%/s. ER_ in the two groups (max and Slope_) (max) there was a significant difference (Z = 1.961,3.203, P0.05, P0.01).ER_ (max), Slope_ (max) ROC curve area and combined the 0.680,0.794 and 0.793 respectively, with the maximum Youden index as the starting value, ER_ (max) 298.33%, Slope_ (max) 5.945%/s two, differential diagnosis of benign and malignant soft tissue tumors, the sensitivity were 58.82% and 82.35%, the specificity was 76% and 72%, the sensitivity of the combined application of both methods was 94.12%, the specificity of 60.00%. TIC and ER_ MRI conclusion dynamic enhanced scanning (max) and Slope_ (max) semi quantitative indicators help identify benign and malignant soft tissue tumors.

【作者單位】： 皖南醫(yī)學(xué)院附屬弋磯山醫(yī)院影像中心;
【分類號(hào)】：R445.2;R738.6

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