DWI在鉴别脊椎良恶性病变中的应用价值

The application value of diffusion weighted MR imaging in identifying spinal benign and malignant lesions

目的:探讨DWI在鉴别脊椎良恶性病变中的应用价值。方法:分析经病理和/(或)临床随访证实的脊柱压缩性骨折患者共50例82个病变椎体,其中良性组20例,34个椎体;恶性组30例,48个椎体。选取50例中的正常椎体35例共35节椎体作为对照组。均行MRI常规序列及DWI扫描;分析良恶性病变的DWI信号特点,并定量测定3组椎体的ADC值,进行统计学分析。结果:良性及恶性组病灶DWI序列均可表现为高、等、低或混杂信号,且2组信号表现差异无统计学意义;良性组、恶性组、对照组ADC值分别为(2.23±0.25)×10-3 mm2/s,(1.62±0.27)×10-3 mm2/s及(0.43±0.34)×10-3 mm2/s,经t检验,各组间ADC值差异均有统计学意义(P<0.05)。结论:DWI信号改变不能用于鉴别椎体良恶性病变,而ADC值具有重要的鉴别诊断价值。

Objective： To discuss the value of diffusion weighted MR imaging in the differentiation of spinal benign and malignant lesions. Methods：We analyzed 50 cases with 82 vertebral lesions confirmed by pathology and（or）clinical follow-ups and selected the nearby normal vertebral body in 35 patients as control group. Diffusion weighted imaging（DWI）and conventional MRI sequences were performed in each case of the study and control group, Vertebra lesions and adjacent normal vertebral in the same sequence and the same level comparison,The signal characteristics of simple and pathologic compression fractures of the vertebral body were analyzed. The apparent diffusion coefficient（ADC）values of the region of interest （ROI） of vertebral body were quantitatively calculated. The signal and ADC value between different groups were compared statistically. Results=Both benign and malignant lesions showed hyper-or isohypo-intensity on DWI sequence without significant difference. The ADC values were（2.23±0.25）×10 ^-3mm^2/s,（1. 62±0. 27） ×10^- 3mm^2/s and（0.43±0.34）×10^-3mm^2/s,respectively. The ADC values among different groups were different statistically by T test（P〈0.05）. Conelusion：DWI signal intensity changes does not help identify benign and malignant vertebral lesions,the ADC values play an important role in the differential diagnosis of benign and malignant vertebral lesions.