本文選題：脊椎腫瘤　切入點：脊索瘤　出處：《中國醫(yī)學(xué)影像學(xué)雜志》2016年08期 　論文類型：期刊論文

【摘要】：目的探討MR T1WI動態(tài)增強成像半定量和定量分析對中軸骨脊索瘤和骨巨細胞瘤鑒別診斷的價值。資料與方法收集2008年6月—2013年10月于北京大學(xué)第三醫(yī)院放射科進行MR T1WI動態(tài)增強掃描并經(jīng)病理證實的中軸骨13例脊索瘤和17例骨巨細胞瘤患者,對兩者后處理分析得到的信號強度-時間曲線類型及應(yīng)用雙室藥物代謝動力學(xué)分析獲得的轉(zhuǎn)運常數(shù)(K~(trans))和速率常數(shù)(k_(ep))進行統(tǒng)計學(xué)分析。結(jié)果 13例脊索瘤中,9例(69.2%)為持續(xù)上升型,4例(30.8%)為平臺型;17例骨巨細胞瘤患者中,11例(64.7%)為速升速降型曲線,6例(35.3%)為平臺型曲線。骨巨細胞瘤Ktrans明顯高于脊索瘤K~(trans)[(0.1247±0.0747)/min比(0.0603±0.0411)/min,P0.01];骨巨細胞瘤的k_(ep)明顯高于脊索瘤的k_(ep)[(0.6629±0.2272)/min比(0.1736±0.1184)/min,P0.01]。以K~(trans)為0.0777/min作為診斷骨巨細胞瘤的閾值時,其診斷的敏感度、特異度分別為89.5%、76.9%;以k_(ep)為0.4339/min作為診斷骨巨細胞瘤的閾值時,其診斷的敏感度、特異度分別為94.7%、100.0%。ROC分析K~(trans)診斷骨巨細胞瘤的曲線下面積為0.826,k_(ep)診斷骨巨細胞瘤的曲線下面積為0.980。結(jié)論MR T1WI動態(tài)增強成像可以為常規(guī)影像學(xué)診斷困難的中軸骨脊索瘤和骨巨細胞瘤的鑒別診斷提供一定的參考。
[Abstract]:Objective to investigate the value of semi-quantitative and quantitative analysis of Mr T1WI dynamic contrast-enhanced imaging in the differential diagnosis between chordoma of the axial bone and giant cell tumor of bone. Materials and methods the data and methods were collected from June 2008 to October 2013 in the Department of Radiology, third Hospital of Peking University. 13 cases of chordoma of the axial bone and 17 cases of giant cell tumor of bone were examined by dynamic contrast-enhanced Mr T1WI and confirmed by pathology. The types of signal intensive-time curves obtained by post-processing analysis and the transport constants (K) and rate constants (K) obtained by two-compartment pharmacokinetic analysis were analyzed statistically. Results in 13 chordoma cases, 9 cases (69.2%) were found. In 17 cases of giant cell tumor of bone, 11 cases (64.7%) and 6 cases (35. 3%) were platform type. The Ktrans of giant cell tumor of bone was significantly higher than that of chordoma (0. 1247 鹵0. 074 7 / min vs 0. 0603 鹵0. 041 鹵0. 01 min / min P0.01); the KepP of giant cell tumor of bone was significantly higher than that of chordoma (P < 0. 05. 01), and that of giant cell tumor of bone was significantly higher than that of chordoma (P < 0. 0603 鹵0. 041 min / min, P < 0. 01), and that of giant cell tumor of bone was significantly higher than that of chordoma. For chordoma (0.6629 鹵0.2272 / min vs 0.1736 鹵0.1184 / min / min P0.01). The sensitivity and specificity of the diagnosis were 89.5% and 76.9%, respectively, and the sensitivity of the diagnosis of giant cell tumor of bone was determined when the threshold value was 0.4339 / min. The area under the curve of diagnosis of giant cell tumor of bone is 0.826 kepepp.) the area under curve of diagnosis of giant cell tumor of bone is 0.980. Conclusion dynamic contrast-enhanced imaging on Mr T1WI can be used to diagnose medial chordoma of bone with difficulty in conventional imaging. The differential diagnosis of giant cell tumor of bone provides some reference.
【作者單位】： 北京大學(xué)第三醫(yī)院放射科;加利福尼亞大學(xué)Tu&Yun腫瘤功能成像中心;
【基金】：國家自然科學(xué)基金(81471634) 北京市自然科學(xué)基金(7164309)
【分類號】：R445.2;R738.1

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