摘要
目的 探讨基于扩散加权成像及MRI对四肢软组织肿瘤(soft tissue tumors,STTs)的诊断价值.方法 选取本院经病理证实的四肢STTs患者 74 例,其中良性 46 例(良性组)、恶性 28 例(恶性组),均行常规MRI、DWI、IVIM及DKI扫描,分析两组常规MRI检查征象及诸参数差异,包括表观扩散系数(ADC)、真实扩散系数(D)、灌注相关扩散系数(D*)、灌注分数(f)、平均扩散峰度值(MK)和平均扩散率(MD);运用ROC曲线分析其诊断效能.结果 恶性组肿瘤边界多不清且呈浸润性生长,以团块状为主,瘤周水肿、筋膜尾征多见,50.0%瘤内可见分隔,两组间差异有统计学意义(P<0.05).恶性组ADC、D和MD值小于良性组,而MK值高于良性组,差异具有统计学意义(P<0.05).D*和f值两组差异无统计学意义(P>0.05).ADC、D、MD、MK值在鉴别四肢STTs良恶性方面均具有一定诊断效能:AUC≥0.688,敏感度≥63.0%,特异度≥67.9%,准确度≥64.9%,其中MD值的诊断效能、特异度最高.ADC+D+MD+MK联合后,AUC为 0.887,诊断效能均高于单一参数(Z=1.978～3.101;P<0.05),敏感度为 76.1%,特异度为 92.9%,准确度 78.4%.结论 基于扩散加权成像及MRI对四肢STTs良恶性有较好的判断价值,值得临床推广.
Abstract
Objective To evaluate the value of magnetic resonance model based on diffusion weighted imaging in the diagno-sis of soft tissue tumors of extremities.Methods 74 patients with pathologically proved soft tissue tumors of extremities,includ-ing 46 benign and 28 malignant tumors,were scanned by routine MRI,DWI,IVIM and DKI.The conventional MRI signs and the differences of parameters between the two groups were analyzed,including apparent diffusion coefficient(ADC),true diffu-sion coefficient(D),perfusion-related diffusion coefficient(D *),perfusion fraction(f),mean diffusion rate(MD),and mean kurtosis value(MK).The diagnostic efficacy was analyzed by ROC curve.The clinical and imaging data of 74 patients with soft tissue tumors of extremities confirmed by pathology were collected and scanned by DWI,IVIM and DKI.The quantitative param-eters such as apparent diffusion coefficient(ADC),true diffusion coefficient(D),perfusion-related diffusion coefficient(D*),perfusion fraction(f),mean diffusion rate(MD),and mean kurtosis value(MK)were analyzed.The ROC was plotted to com-pare the diagnostic efficiency.Results In the malignant group,the tumor boundary was unclear.Peritumoral infifiltration,in-tratumoral septa and mainly mass,peritumoral edema and fascia tail sign were more common.The above MRI features were statis-tically different in the benign and malignant groups(P<0.05).The values of ADC,D and MD in malignant group were lower than those in benign group,while,the value of MK in malignant group was higher than that in benign group(P<0.05).There was no significant difference in D* and f values between the two groups.ADC,D,MD and MK values had certain diagnostic ef-ficiency in distinguishing benign and malignant STTs of extremities:AUC≥0.688,sensitivity≥63.0%,specificity≥67.9%,accu-racy≥64.9%,among which MD value had the highest diagnostic efficacy and specificity.After the combination of ADC+D+MD+ MK,the AUC was 0.887,the diagnostic efficiency was higher than that of a single index(Z= 1.978-3.101,P<0.05),the sensi-tivity was 76.1%,the specificity was 92.9%,and the accuracy was 78.4%.Conclusion The magnetic resonance model based on diffusion-weighted imaging has good value in judging benign and malignant soft tissue tumors of extremities,which is worth popularizing in clinic.
基金项目
山东省医药卫生科技发展计划(202109010447)
山东省济宁市重点研发计划(2020YXNS012)
NETL
NSTL
维普
万方数据