| 李莹,任翠萍,程敬亮,李贝贝,肖翠萍,王乾.磁共振弥散加权成像及波谱成像评价原发性骨肉瘤恶性程度[J].中国医学影像技术,2017,33(11):1700~1704 |
| 磁共振弥散加权成像及波谱成像评价原发性骨肉瘤恶性程度 |
| Diffusion weighted imaging and magnetic resonance spectroscopy in evaluation of malignant degree of primary osteosarcoma |
| 投稿时间：2017-02-08 修订日期：2017-09-07 |
| DOI：10.13929/j.1003-3289.201702030 |
| 中文关键词: 骨肉瘤 扩散磁共振成像 磁共振波谱 |
| 英文关键词:Osteosarcoma Diffusion magnetic resonance imaging Magnetic resonance spectroscopy |
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| 中文摘要: |
| 目的 探讨DWI和1H-MRS对不同恶性程度原发性骨肉瘤的诊断价值。方法 回顾性分析41例经病理证实的骨肉瘤患者的DWI和1H-MRS检查资料。DWI检查中b值分别为0、400、800、1 000、1 500 s/mm2，经后处理获得相应的ADC图，并计算ADC值。对18例MRS谱线稳定的骨肉瘤患者进行分析并获得MRS谱线、胆碱复合物（Cho）、肌酸（Cr）及Cho/Cr值。不同b值下高度和低度恶性骨肉瘤的ADC值比较采用Kruskal-Wallis H检验，Cho/Cr值的比较采用Mann-Whitney U检验。结果 当b值分别为400、800、1000 s/mm2时，高度与低度恶性骨肉瘤的ADC值差异有统计学意义（χ2=6.26、4.37、4.87，P=0.01、0.04、0.03）；而b值为1 500 s/mm2时，高度与低度恶性骨肉瘤ADC值差异无统计学意义（χ2=2.39，P=0.12）。b值为400 s/mm2时，以ADC值诊断高度恶性骨肉瘤的特异度和敏感度为73.30%和72.70%。高、低度恶性骨肉瘤的Cho/Cr值差异有统计学意义（Z=-2.45，P<0.05）。以Cho/Cr诊断高度恶性骨肉瘤的最佳界值为2.21，特异度为75.00%，敏感度为92.90%。结论 ADC值（b值取400 s/mm2）及Cho/Cr值均对诊断原发性骨肉瘤的恶性程度有一定价值。 |
| 英文摘要: |
| Objective To explore the value of DWI and 1H-MRS in evaluation of malignant degree of primary osteosarcoma. Methods A retrospective analysis was performed in 41 patients with osteosarcoma confirmed pathologically and examined with DWI and 1H-MRS. The b values were 0, 400, 800, 1 000 and 1 500 s/mm2 in DWI, respectively. ADC map was obtained, and ROIs were selected to measure ADC values. Eighteen cases which had stable spectral lines in MRS were selected and analyzed. The spectral lines, Choline (Cho), Creatine (Cr) and Cho/Cr ratio were obtained. Analysis of ADC values of high and low grade osteosarcoma were performed with Kruskal-Wallis H test, and Cho/Cr values were analyzed with Mann-Whitney U test. Results When b values were 400, 800, 1 000 s/mm2, ADC values of high and low grade osteosarcoma were significantly different (χ2=6.26, 4.37, 4.87, P=0.01, 0.04, 0.03). When b value was 1 500 s/mm2, ADC value of high and low grade osteosarcoma had no statistical difference (χ2=2.39, P=0.12). Moreover, when 400 s/mm2 was taken as the optimal b value, the specificity and sensitivity of ADC value for identifying high grade osteosarcoma was 73.30% and 72.70%,respectively. Cho/Cr values between high and low grade osteosarcoma were significantly different (Z=-2.45, P<0.05). As a diagnostic parameter, the best threshold value of Cho/Cr was 2.21. And the specificity and sensitivity for diagnosing high grade osteosarcoma was 75.00% and 92.90%,respectively. Conclusion ADC (b=400 s/mm2) and Cho/Cr values may be helpful to identifying malignant degree in osteosarcoma. |
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