ADC值在鉴别脊椎良恶性压缩骨折中的价值

Differential Diagnosis Value of Apparent Diffusion Coefficient in Benign and Malignant Vertebral Compression Fractures

目的探讨弥散加权成像(Diffusion weighted imaging,DWI)中ADC值在鉴别脊椎良恶性压缩骨折中的价值。方法回顾分析经病理和(或)临床随访证实的椎体压缩骨折85例共147节椎体,其中恶性组55例共100节椎体;良性组30例共47节;选取同一患者病变椎体附近的正常椎体组成对照组69例共69节椎体。b值为0、300s/mm2。并测量良性组、恶性组及对照组相应椎体的表观弥散系数(apparent diffusion coefficient,ADC)值,计数并做统计学分析。结果良性组、恶性组及对照组ADC值分别为:(6.95±1.97)×10-4mm2/s、(4.54±1.10)×10-4mm2/s及(1.41±0.84)×10-4mm2/s,经T检验,良恶性组间、良恶性组与对照组间ADC值差异均有统计学意义(p<0.05)。结论 ADC值定量测定对鉴别脊椎良恶性压缩骨折的病因有一定价值,但部分存在重叠。

Objective To evaluate the differential diagnosis value of apparent diffusion coeffient （ADC） values in benign and malignant vertebral compression fractures. Method Retrospective review of diffusion weighted MR （SE EPI sequence） of 85 patients （147 vertebral fractures） with pathologically or （and） clinically proven, of which 55 were malig- nant fractures, and 30 benign fractures （1 7 traumatic： 13 osteoporotic）. The contrast group was composed of 69 patients with 69 normal vertebrae adjacent to abnormal vertebrae. The b-value was 0, 300s/mm2. Apparent diffusion coeffient （ADC） values of normal and abnor- mal vertebral bodies were calculated. ADC values of vertebral bodies were quantitatively analyzed and compared in the benign, malignant and normal groups. Resttlts ADC vahtes of benign, malignant and normal group were （6.95 ± 1.97） ×10-4mm2/s, （4.54 ± 1.10） × 10 -4mm2/s and （1 .41± 0.84）× 10-4mm2/s respectively; the differences of ADC values were statistically significant among benign, malignant and normal group （P〈0.05）. Concluion Difference ADC value were useful in differentiating benign from malignant vertebral body compression fractures, but there might be overlapped of them.