磁共振成像在良、恶性软组织肿瘤鉴别诊断中的价值

Diagnostic value of MRI in differentiating benign and malignant soft-tissue tumors

目的:分析磁共振成像在良、恶性软组织肿瘤鉴别诊断中的价值。方法:回顾性分析经手术病理证实的31例软组织良、恶性肿瘤的MRI资料。所有病例均行MRI平扫及增强扫描检查,其中15例行MRI动态增强扫描检查,分析观察MRI异常征象特征及时间-信号强度曲线(TIC)的形态特点,良、恶性软组织肿瘤MRI征象分析采用Fisher精确概率法检验,两组间TIC的差异采用秩和检验分析。结果:31例软组织肿瘤包括11例恶性肿瘤,20例良性肿瘤。在软组织良、恶性肿瘤的MRI异常征象中,肿瘤大小、强化方式及侵袭性的差异具有统计学意义(P<0.05),肿瘤边界、T2WI信号均匀性及瘤周水肿的差异无统计学意义(P>0.05)。动态增强扫描,8例良性肿瘤的TIC有6例呈渐增型,2例呈平台型;7例恶性肿瘤的TIC有1例呈渐增型,3例呈平台型,3例呈流出型。两组间差异具有统计学意义(Z=-2.500,P<0.05)。结论:肿瘤大小、强化方式及侵袭性结合动态增强扫描的TIC在良、恶性软组织肿瘤鉴别诊断中具有重要意义。

Objective： To assess the value of MRI in differentiating benign and malignant soft-tissue tumors. Methods： MRI information was reviewed in 31 cases of soft tissue tumors confirmed postoperatively by pathology. All patients received preoperative plain MRI and enhanced MRI scans,among whom 15 underwent dynamic contrast-enhanced MRI examination. Abnormal signs and time signal intensity curve（ TIC） on MRI were observed regarding the benign and malignant tissue tumor and analyzed by Fisher exact probability test. Rank sum test was used to analyze the difference of TIC between the two groups.Results： In the 31 cases,11 were malignant tumor,and 20 benign. The difference was significant pertaining the tumor size,invasiveness and enhancement pattern between benign and malignant tumors（ P〈0. 05）,yet was not significant regarding the tumor boundary,T2 WI signal and adjacent edema（ P〈0. 05）. TIC in 6 cases of the benign tumors were type-I curve（ incremental type） and 2 type-II curve（ platform type）,and TIC in 7 malignancies,1 was present with type-I curve（ incremental type）,3 were type-type curve（ platform type） and another 3,type-Ⅲ curve（ outflow type）. The two groups were statistically different（ Z =- 2. 500,P〈0. 05）. Conclusion： Tumor size,enhancement and invasiveness with dynamic enhanced scan of TIC has important significance for differential diagnosis of benign and malignant soft tissue tumors.