双指数表观扩散系数鉴别诊断椎体良、恶性病变

Biexponential apparent diffusion coefficient in differential diagnosis between benign and malignant lesions of vertebral body

目的探讨多b值双指数衰减模型的DWI对椎体良、恶性病变的鉴别诊断价值。方法对22例椎体疾病患者(共34个病变椎体)行多b值双指数衰减模型的DWI(b值为0、50、100、200、400、600、800、1000s/mm2),其中良性病变13例(21个椎体,良性组),恶性病变9例(13个椎体,恶性组)。以患者自身正常椎体作为对照组(共34个正常椎体)。通过AW 4.3工作站测量并两两比较3组间的Fast ADC及Slow ADC值。结果良性组、恶性组及对照组Fast ADC分别为(4.31±1.48)×10-3 mm2/s、(2.85±1.26)×10-3 mm2/s、(0.86±0.63)×10-3 mm2/s,Slow ADC分别为(0.68±0.08)×10-3 mm2/s、(0.38±0.08)×10-3 mm2/s、(0.23±0.04)×10-3 mm2/s。3组间Fast ADC及Slow ADC差异均有统计学意义(P均<0.05)。结论多b值双指数衰减模型的DWI可为鉴别诊断椎体良、恶性病变提供有价值的组织学参数(Fast ADC及Slow ADC)。

Objective To investigate the application value of DWI based on biexponential signal decay modeling with extended b-factor range in differential diagnosis of benign and malignant lesions of vertebral body.Methods A total of 22 patients with vertebral body tumor underwent DWI based on the biexponential signal decay modeling with extended b-factor range.Among them,benign lesions were found in 13 cases（21 vertebral body,benign group）,while malignant metastasis were found in 9 cases（13 vertebral body,malignant group）.Normal vertebral bodies of the same patients were used as control（34 vertebral body,control group）.Paired comparison of Fast ADC and Slow ADC values between the 3 groups were separately performed using MADC analysis software on AW 4.3 workstation.Results Fast ADC was（4.31±1.48）×10-3 mm2/s,（2.85±1.26）×10-3 mm2/s and（0.86±0.63）×10-3 mm2/s in benign,malignant and control groups,while Slow ADC of the 3 groups was（0.68±0.08）×10-3 mm2/s,（0.38±0.08）×10-3 mm2/s and（0.23±0.04）×10-3 mm2/s,respectively.Significant differences of Fast ADC and Slow ADC were found among the 3 groups with pairwise comparison（all P0.05）.Conclusion Biexponential signal decay modeling of DWI with extended b-factor range can provide significant tissue characterization parameters for differential diagnosis between benign and malignant lesions of vertebral body.