黏液基质对肌骨肿瘤表观扩散系数测定及诊断价值的影响

Influence of Myxoid Matrix on the Apparent Diffusion Coefficient Measurement and Diagnosis Value in Musculoskeletal Tumors

目的探讨肌骨肿瘤中黏液基质对其表观扩散系数(ADC)测定的影响及ADC值鉴别诊断价值的影响。方法对经病理证实的21例富含黏液基质的肌骨肿瘤患者术前行磁共振扩散加权成像(DWI)检查,测量肿瘤实质区ADC值。对照组为29例其他类不含黏液基质肌骨肿瘤。统计分析富含黏液组与对照组间ADC值差异,各组中良、恶性肿瘤间的ADC值差异。结果 (1)富含黏液类肿瘤ADC值均>2.0×10-3mm2/s,平均ADC值为(2.32±0.15)×10-3mm2/s,对照组肿瘤平均ADC值为(1.39±0.37)×10-3mm2/s,两者间差异有统计学意义(t=4.60,P<0.05);(2)富含黏液类肿瘤组中,良、恶性肿瘤平均ADC值分别为(2.10±0.21)×10-3mm2/s、(2.05±0.14)×10-3mm2/s,两者间差异无统计学意义(t=0.68,P>0.05)。(3)不含黏液类肿瘤组中,良、恶性肿瘤平均ADC值分别为(1.41±0.36)×10-3mm2/s、(0.94±0.31)×10-3mm2/s,两者间差异有统计学意义(t=1.72,P<0.05)。结论肌骨肿瘤中的黏液基质成分可使测得的肿瘤ADC值增高且>2.0×10-3mm2/s。在不含黏液基质成分的肌骨肿瘤中,ADC值可用来对良、恶性肿瘤鉴别诊断。

Objective To investigate influence of myxoid matrix on the apparent diffusion coefficient measurement and diagnosis value in Museuloskeletal Tumors. Methods The 21 cases of myxoid-eontaining musculoskeletal tumors were examined by conventional MRI and DWI scan before operation. The control group consisted of 29 cases with nonmyxoid musculoskeletal tumors, We then compared the ADC values of the myxoid and nonmyxoid tumors ; the benign and malignant myxoid tumors ; the benign and malignant nonmyxoid tumors. Results （1）The myxoid-eontaining and nonmyxoid group of the mean ADC values were（ mean ±SD 2.32 ±0.15 ）×10^-3mm^2/s and （1.39 ±0.37 ）×10^-3mm^2/s respectively, the myxoid-coutaining group ADC value is higher than 2.0 ×10^-3mm^2/s, the difference was statistically significant（ t = 4. 60, P 〈 0. 05 ） ; （2） In the myxoid-containing tumors group, The mean ADCs of benign and malignant tumors were （2.10 ±0. 21 ） ×10^-3mm^2/s and （2.05 ± 0.14） ×10^-3mm^2/s respectively, whereas The differences of the both groups showed no significance statistically （t = 0. 68, P 〉 0.05 ） ; （2）In the nonmyxoid tumors group, The mean ADCs of benign and malignant tumors were（ 1.41±0.36） ×10^-3mm^2/s and （0.94±0.31 ） ×10^-3mm^2/s respectively, The differences of the both groups showed statistical significance （ t = 1.72, P 〈 0.05 ）. Conclusion The myxoid matrix composition in muscaloskeletal tumor could lead to increased ADC. the ADC value is higher than 2.0×10^-3mm^2/s, The ADC value has great importance in differential diagnosis of benign and malignant nonmyxoid tumors.