| 宋晓,刘文佳,李新星,王超,李涛.常规MRI与弥散加权成像鉴别诊断良、恶性周围神经鞘肿瘤[J].中国医学影像技术,2024,40(3):346~350 |
| 常规MRI与弥散加权成像鉴别诊断良、恶性周围神经鞘肿瘤 |
| Conventional MRI and diffusion weighted imaging for differential diagnosis of benign and malignant peripheral nerve sheath tumors |
| 投稿时间：2023-09-22 修订日期：2023-11-19 |
| DOI：10.13929/j.issn.1003-3289.2024.03.006 |
| 中文关键词: 神经鞘肿瘤 磁共振成像 |
| 英文关键词:nerve sheath neoplasms magnetic resonance imaging |
| 基金项目: |
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| 中文摘要: |
| 目的 采用常规MRI与弥散加权成像(DWI)鉴别诊断良、恶性周围神经鞘肿瘤(PNST)。方法 回顾性分析119例经病理证实的PNST患者 MRI资料,比较恶性PNST(MPNST,n=31)与良性PNST(BPNST,n=88)病灶直径、MRI表现及DWI所示实性部分表观弥散系数(ADC);绘制受试者工作特征曲线,评价以病灶实性部分ADC鉴别诊断良、恶性PNST的价值。结果 MPNST病灶直径大于BPNST,T1WI、T2WI信号不均、形状不规则、瘤内出血及囊变、边缘不清、瘤周水肿及骨破坏占比均高于BPNST(P均＜0.05),而脂肪分裂征、脂肪环征、靶征及骨重塑占比低于BPNST(P均＜0.05)。共于12例MPNST及27例BPNST测得病灶内实性部分ADC,MPNST最小ADC及平均ADC均低于BPNST(P均＜0.05)。以最小ADC 1.27×10－3 mm2/s、平均ADC 1.38×10－3 mm2/s为阈值鉴别良、恶性PNST的曲线下面积分别为0.765、0.755。结论 良、恶性PNST常规MRI及DWI表现存在差异;病灶直径、形状、信号、实性部分ADC及瘤周改变等有助于鉴别。 |
| 英文摘要: |
| Objective To differentiate benign and malignant peripheral nerve sheath tumors (PNST) with conventional MRI and diffusion weighted imaging (DWI). Methods MRI data of 119 patients with PNST confirmed by pathology were retrospectively analyzed. Lesion's diameter, MRI features and the apparent diffusion coefficient (ADC) of the solid part of lesion showed on DWI were compared between malignant PNST (MPNST, n=31) and benign PNST (BPNST, n=88). The receiver operating characteristic curves were drawn for evaluating the value of ADC in the solid part of lesion for distinguishing benign and malignant PNST. Results The diameter of MPNST lesions were larger than that of BPNST, and the proportion of uneven signal on T1WI and T2WI, irregular shape, intratumoral bleeding and cystic changes, unclear margins, peritumoral edema and bone destruction in MPNST were all higher than those in BPNST (all P＜0.05), whereas the proportion of fat division sign, fat ring sign, target sign and bone remodeling were all lower than that in BPNST (all P＜0.05). ADC of the solid components of lesions were obtained in 12 MPNST and 27 BPNST, and both the minimum and the average ADC in MPNST were lower than those in BPNST (both P＜0.05). Taken 1.27×10－3 mm2/s and 1.38×10－3 mm2/s as the cutoff value of the minimum ADC and the average ADC, respectively, the area under the curve (AUC ) for distinguishing benign and malignant PNST was 0.765 and 0.755, respectively. Conclusion MRI and DWI manifestations of benign and malignant PNST were different to a certain extent. Lesion's diameter, shape, signal characteristics, ADC of the solid component, and perilesional alterations were helpful for differential diagnosis. |
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