DTI技术在四肢软组织肿瘤良恶性鉴别中的价值

The value of diffusion tensor imaging in the differential diagnosis of benign and malignant of limb soft tissue tumor

目的探讨扩散张量成像(diffusion tensor imaging,DTI)技术在四肢软组织肿瘤良恶性鉴别中的价值。方法回顾性分析22例经手术病理证实的四肢软组织肿瘤的DTI资料(恶性肿瘤12例,良性肿瘤10例),定量分析良恶性肿瘤部分各向异性值(fractional anisotropy,FA)、相对各向异性值(relative anisotropy,RA)及表观弥散系数值(apparent diffusion coefficient,ADC),并对可疑肿瘤侵犯部位进行肌纤维示踪,评估肌纤维形态。结果四肢软组织恶性肿瘤的FA值、RA值及ADC值分别为0.30±0.11、0.25±0.10、(0.91±0.16)×10-3 mm2/s,良性肿瘤的FA值、RA值及ADC值分别为0.11±0.09、0.12±0.08、(1.39±0.25)×10-3 mm2/s,良恶性肿瘤的FA值、RA值及ADC值均有统计学差异(P>0.05)。良性肿瘤周围肌纤维形态学改变为水肿、移位,恶性肿瘤的周围肌纤维主要为侵犯、破坏。结论 DTI通过显示肿瘤周围肌纤维形态变化并对肿瘤实质进行定量测量,可提高四肢软组织肿瘤正确诊断率。

Objective To assess the value of DTI in the differential diagnosis of benign and malignant limb soft tissue tumor.Methods Various clinical parameters,including DTI data,were analyzed in 22 patients;the FA,RA and ADC data were quantitative analysed using magnetic resonance imaging diffusion tensor data and three dimension tracing technique to trace and evaluate muscle fiber morphology.Results The FA,RA and ADC data of malignant limb soft tissue tumor were 0.30±0.11,0.25±0.10,（0.91±0.16）×10^-3 mm^2/s.Compared to 0.11±0.09,0.12±0.08,（1.39±0.25）×10^-3 mm^2/s in benign tumor,there was significant difference between them（P〈0.05）.The muscle fiber around benign tumor constant expression was edema,shift,compared to infringement or damage in malignant tumor.Conclusion DTI could not only clearly show the changes of muscle fiber around benign tumor,but also make the quantitative measurement.