本文選題：骨肉瘤 + 磁共振��； 參考：《山東醫(yī)藥》2017年23期

【摘要】：目的對比低、高度惡性原發(fā)性骨肉瘤患者磁共振彌散加權成像(DWI)、磁共振波譜成像(MRS)、動態(tài)增強掃描(DCE)檢查結果,探討低、高度惡性原發(fā)性骨肉瘤患者磁共振DWI、MRS、DCE檢查結果的特點。方法將41例骨肉瘤患者分為低度惡性組和高度惡性組,病灶均行DWI、1H-MRS、DCE檢查。DWI序列選用5個不同的彌散敏感系數(shù)(b值),分別是0、400、800、1 000、1 500 s/mm2,經(jīng)后處理得到相應的表觀彌散系數(shù)(ADC)圖,選擇感興趣區(qū)計算ADC值,比較不同b值下低、高度惡性原發(fā)性骨肉瘤患者病灶的ADC值。對18例MRS譜線穩(wěn)定的骨肉瘤患者病灶的MRS譜線進行分析,計算Cho/Cr值,比較低、高度惡性原發(fā)性骨肉瘤患者病灶的Cho/Cr值,用受試者工作曲線確定用Cho/Cr值鑒別低、高度惡性原發(fā)性骨肉瘤的最佳診斷界值。繪制病灶DCE的時間-信號強度曲線(TIC),比較低、高度惡性原發(fā)性骨肉瘤患者病灶TIC類型的差異。結果低度惡性組、高度惡性組病灶ADC0-400分別為(1 100.00,1875.00)、(977.25,1 434.00),ADC0-800分別為(51.00,1 410.00)、(844.75,1 259.00),ADC0-1000分別為(939.00,1 246.00)、(791.75,1122.50),ADC0-1500分別為(799.00,1 100.00)、(654.75,969.50),兩組患者病灶ADC0-400、ADC0-800、ADC0-1000相比,P均0.05。18例骨肉瘤患者病灶MRS譜線均出現(xiàn)Cho峰,7例未出現(xiàn)Lip峰。高、低度惡性骨肉瘤患者病灶的Cho/Cr值分別是(2.703,4.883)、(1.045,2.695)。高、低度惡性骨肉瘤患者病灶的Cho/Cr值相比有統(tǒng)計學差異(Z=-2.445,P0.05)。以Cho/Cr值作為診斷指標繪制ROC曲線,曲線下面積為0.718,特異度為66.7%,敏感度為72.2%,最佳診斷界值為Cho/Cr=2.3。低度惡性組病灶TIC類型為Ⅰ型2例、Ⅱ型5例,Ⅲ型4例,高度惡性組分別為20、10、0例。兩組病灶TIC類型分布相比,χ~2值為10.876,P0.05。結論高度惡性原發(fā)性骨肉瘤患者病灶DWI檢查ADC值低于低度惡性原發(fā)性骨肉瘤患者。高度惡性原發(fā)性骨肉瘤患者病灶MRS檢查Cho/Cr值高于低度惡性原發(fā)性骨肉瘤患者。以Cho/Cr=2.3為界值可以鑒別低、高度惡性原發(fā)性骨肉瘤。行DCE檢查時,高度惡性原發(fā)性骨肉瘤病灶TIC類型多為Ⅰ型,而低度惡性原發(fā)性骨肉瘤TIC類型多為Ⅲ型。
[Abstract]:Objective to compare the results of Mr diffusion weighted imaging (DWI), magnetic resonance spectrum imaging (MRS) and dynamic contrast enhanced scanning (DCEE) in patients with low and high malignant primary osteosarcoma, and to explore the characteristics of DWIMr Mr Mr Mr Side-DCE (DCE) in patients with low and high malignant primary osteosarcoma. Methods 41 patients with osteosarcoma were divided into low grade malignant group and high malignant group. The lesions were examined by DWI1H-MRSU DCE. DWI sequences were divided into 5 different diffusion-sensitive coefficient (DWI), which were 0.400800 ~ 1 000 ~ 1 000 s / m ~ (2), respectively. The corresponding apparent diffusion coefficient (ADC) images were obtained by post-processing. The ADC value was calculated by selecting the region of interest, and the ADC values of the lesions in the patients with primary malignant osteosarcoma were compared under different b values. The MRS spectra of 18 patients with osteosarcoma with stable MRS spectrum were analyzed. The Cho/Cr value was calculated. The Cho/Cr value of the lesions in the patients with high malignant primary osteosarcoma was lower than that in the patients with high malignant osteosarcoma. The Cho/Cr value was determined by the operating curve of the subjects. The best diagnostic limit for high malignant primary osteosarcoma. The time-signal intensity curve of DCE was drawn to compare the difference of TIC type in patients with low and high malignant primary osteosarcoma. 緇撴灉浣庡害鎭舵，

本文編號：1891350