王琦, 鲍润贤, 叶兆祥, 刘佩芳, 肖渤瀚, 汪沁. 磁共振扩散加权成像鉴别良恶性软组织肿瘤的价值[J]. 中国肿瘤临床, 2008, 35(23): 1331-1334.
引用本文: 王琦, 鲍润贤, 叶兆祥, 刘佩芳, 肖渤瀚, 汪沁. 磁共振扩散加权成像鉴别良恶性软组织肿瘤的价值[J]. 中国肿瘤临床, 2008, 35(23): 1331-1334.
WANG Qi, BAO Run-xian, YE Zhao-xiang, LIU Pei-fang, XIAO Bo-han, WANG Qin. Evaluation of Diffusion-weighted Imaging for the Differential Diagnosis of Soft-tissue Tumors[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2008, 35(23): 1331-1334.
Citation: WANG Qi, BAO Run-xian, YE Zhao-xiang, LIU Pei-fang, XIAO Bo-han, WANG Qin. Evaluation of Diffusion-weighted Imaging for the Differential Diagnosis of Soft-tissue Tumors[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2008, 35(23): 1331-1334.

磁共振扩散加权成像鉴别良恶性软组织肿瘤的价值

Evaluation of Diffusion-weighted Imaging for the Differential Diagnosis of Soft-tissue Tumors

  • 摘要: 目的 :探讨磁共振扩散加权成像(DWI)鉴别良恶性软组织肿瘤的价值。 方法 :采用扩散加权成像分析43例软组织肿瘤,其中恶性25例,良性18例。所有病例均经手术病理证实。扩散加权成像的扩散敏感因子(b值)为0,500s/mm2。选取肿瘤实体部分最大感兴趣区,尽量避开坏死、出血、瘢痕及钙化等不均质成分。分析各病灶的扩散加权图像特点,比较良、恶性肿瘤表观扩散系数(apparent diffusion coefficient,ADC)的差异。3例恶性肿瘤患者化疗前、后进行DWI检查,分析ADC值的变化特点。 结果 :恶性肿瘤的ADC值(0.96±0.31×10-3)mm2/s明显低于良性肿瘤的ADC值(1.92±0.63×10-3)mm2/s和肌肉组织(1.69±0.47×10-3)mm2/s的ADC值,差异具有统计学意义(P<0.05),良性肿瘤与肌肉的ADC值无明显差异。ADC值为(1.38×10-3)mm2/s时,鉴别良恶性肿瘤的敏感性为92%,特异性为83%。3例恶性肿瘤患者化疗前、后进行DWI检查,其中2例化疗后ADC值升高,1例无ADC值的明显变化。 结论 :ADC值在软组织良恶性肿瘤的鉴别诊断中具有重要价值,ADC值对于化疗效果评价的作用需要进一步研究并与组织学对照加以证实。

     

    Abstract: Objective : To explore the potential value of diffusion-weighted magnetic resonance imaging (MRI) incharacterizing soft-tissue tumors. Methods : Diffusion-weighted MRI was performed in 43 histologically provensoft-tissue tumor cases using diffusion-weighted spin-echo sequences. Of the 43 soft-tissue tumor cases,there were 25 cases of sarcoma and 18 cases of benign tumor. The b values of diffusion were 0 and 500 s/mm2. The apparent diffusion coefficient (ADC) values of a large region with no necrosis, scar tissue, hemor-rhage or calcification representing the lesion were measured. ADC values of benign tumors, malignant tumorsand normal muscles were compared. ADC values of different histological malignancy (grade Ⅱ, Ⅲand Ⅳ)were compared. Three patients with malignant tumors (2 cases of primitive neuroectodermal tumor and 1case of rhabdomyosarcoma) underwent diffusion weighted MRI before and after chemotherapy. We evaluatedthe changes in ADC values. Results : The ADC values of the malignant tumors (mean±SD, 0.96±0.31×10-3mm2/s) were significantly lower than those of benign lesions (1.92±0.63×10-3mm2/s) and muscles (1.69±0.47×10-3mm2/s). There was no significant difference in ADC values between benign lesions and muscles. High sensitiv-ity (92%) and specificity (83%) were obtained when the ADC value was 1.38×10-3mm2/s in the differentiationof benign and malignant tumors. No significant difference was found in ADC values among groups of differenthistological grades of malignancy. In the 3 patients with malignant tumors who underwent diffusion-weightedMRI before and after chemotherapy, ADC values after treatment of 2 cases were increased due to mi-cro-necrosis but there were no obvious changes in the other case. Conclusion : Diffusion-weighted MRI has po-tential value in differentiating benign soft-tissue tumors from malignant ones. The increase of ADC values ofsoft-tissue sarcoma after chemotherapy warrants further studies of diffusion weighted imaging and histologi-cal assessment for evaluating therapeutic reaction.

     

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