文章摘要
杨宏志 刘国军 杜笑松 李延静 巴红珍.MR 弥散加权成像对鉴别诊断良恶性椎体压缩性骨折的临床价值研究[J].,2014,14(9):1689-1692
MR 弥散加权成像对鉴别诊断良恶性椎体压缩性骨折的临床价值研究
Clinical Value of MR Diffusion Weighted Imaging in the DifferentialDiagnosis of Benign and Malignant Vertebral Compression Fractures
  
DOI:
中文关键词: MR 弥散加权成像  椎体  压缩性骨折  鉴别诊断
英文关键词: MR diffusion weighted imaging  Vertebral  Compression fracture  Differential diagnosis
基金项目:院内研究生创新基金项目(11YJ22)
作者单位
杨宏志 刘国军 杜笑松 李延静 巴红珍 延安大学附属医院
山西省肿瘤医院 
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中文摘要:
      目的:探讨MR弥散加权成像(DWI)鉴别诊断良恶性椎体压缩性骨折的临床价值。方法:对57 例经临床或病理证实的椎体 良恶性压缩性骨折患者行矢状位T1WI、T2WI、T2WI/FS 及DWI扫描,研究其在常规序列和DWI序列上的表现,将常规MR 序列 和DWI序列检出率进行比较,测量正常椎体及病变椎体的表观弥散系数(ADC)值,并进行统计学分析。结果:(1)MR 常规序列和 DWI序列(b=500s/mm2)表现:良性椎体压缩性骨折呈长T1 长或等T2 改变,T2WI/FS 呈高信号,DWI 可以呈高信号、等信号及低 信号;恶性椎体压缩性骨折呈长T1 长T2 信号,大部分病灶T2WI/FS 及DWI呈高信号,少数变现为低信号;(2)MR 常规序列和 DWI 序列(b=500s/mm2)病灶检出率的比较:T1WI、T2WI/FS 及DWI序列病灶检出率均高于T2WI 序列,其间的差别有显著性意 义(P<0.01),T1WI、T2WI/FS 及DWI序列病灶检出率之间无显著性差异(P>0.01);(3)ADC 值比较:在DWI(b=500 s/mm2)上,良性组 ADC 值为(2.03± 0.83)× 10-3mm2/s,恶性组ADC 值为(1.37 ± 0.75)× 10-3mm2/s,正常组ADC值为(0.36± 0.21)× 10-3mm2/s,成像条 件相同时,良性组高于恶性组,两组间有明显的统计学意义(P<0.05)。结论:DWI可较好的反映椎体的弥散特征,ADC值作为量化 指标可对良恶性椎体压缩性骨折进行可靠鉴别。
英文摘要:
      Objective:To investigate the clinical value of MR diffusion weighted imaging in the differential diagnosis of benign and malignant vertebral compression fractures.Methods:57 patients with vertebral compression fractures(confirmed by clinic or pathology) were performed with sagittal T1WI, T2WI, T2WI/FS and DWI respectively. The capability to show the lesion on T1WI、T2WI、 T2WI/ FS and DWI (b=500 s/mm2)were compared. Meanwhile, on DWI(b=500 s/mm2), the ADCs of the vertebral compression fractures and normal vertebral were analyzed.Results:(1)The appearance of routine MR sequence and DWI sequence (b=500s/mm2): benign vertebral compression fractures showed long T1, long T2, T2WI/FS high signal, DWI could display high and low signal; malignant vertebral compression fractures long T1 and long T2 signal, most lesions on T2WI/FS and DWI showed high signal, few ones low signal; (2)The capability to show the lesions on DWI(b=500 s/mm2) and general MRI. The capability to show the lesions on T1WI, T2WI/FS and DWI (b=500 s/mm2) were similar(P >0.01), which were higher than that of T2WI(P <0.01). (3)The ADCs of lesions and normal vertebrae were: b=500 s/mm2,the benign group ADC value(2.03 ± 0.83)× 10-3 mm2/s, the malignant group (1.37 ± 0.75)× 10-3 mm2/s, the normal group (0.36 ± 0.21)× 10-3 mm2/s. The ADCs of benign group were higher than that of malignant group(P<0.01).Conclusion:DWI could efficiently reflect the diffusion characterizations. The benign and malignant vertebral compression fractures could be reliably distinguished by comparing the ADC.
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