磁共振扩散加权成像在滑膜肉瘤诊治中的应用

Appficatlon value of diffusion weighted imaging in the diagnosis and treatment of synovial sarcoma

目的探讨磁共振扩散加权成像（DWI）在滑膜肉瘤诊治中的应用价值。方法选取经病理证实的滑膜肉瘤患者48例,所有患者给予常规磁共振成像（MRI）和DWI检查,DWI的扩散敏感因子（b值）为500s/mm2,统计分析所有患者成像结果和疾病检出情况,应用ROC曲线分析DWI、MRI对滑膜肉瘤的诊断价值。结果DWI检测对滑膜肉瘤的检出率为93.75%,明显高于MRI的83.33%,差异有统计学意义（χ2=5.62,P〈0.05）;ROC曲线分析结果显示,MRI对滑膜肉瘤的诊断特异性为72.58%,敏感性为79.12%,准确度为86.82%,DWI的诊断特异性为76.81%,敏感性为85.79%,准确度为95.18%;DWI检测滑膜肉瘤敏感性、特异性和准确度明显高于常规MRI检测,两者差异均有统计学意义（χ2=5.72、5.68、5.12,均P〈0.05）。结论DWI可有效提高滑膜肉瘤的检出率,具有更高的诊断敏感性、特异性和准确性,有利于医师及时进行治疗,值得临床作进一步推广。

Objective To discuss the application value of diffusion weighted imaging（ DWI） in the diagnosisand treatment of synovial sarcoma. Methods 48 patients with synovial sarcoma were selected. All patients were givenconventional magnetic resonance imaging （ MRI） and DWI detection examination, DWI diffusion sensitive factorexamination was 500 s/ was（ b） . All the patients＇imaging results and disease detection were analyzed. ROC curve wasused to analyze the value of DWI, MRI examination in the diagnosis of synovial sarcoma. Results DWI examinationdetection of synovial sarcoma was much higher than that of MRI, the difference was statistically significant（ χ 2 =5. 62,P 〈0. 05） . ROC curve analysis showed that MRI examination in the diagnosis of synovial sarcoma specificity was72 58%, sensitivity was 79. 12%, the accuracy was 86. 82%, DWI examination in the diagnosis of specificity was76 81%, sensitivity was 85. 79%, the accuracy was 95. 18%. The sensitivity, specificity and accuracy of DWI weresignificantly higher than conventional MRI, the differences were significant（ χ 2 = 5. 72, 5. 68, 5. 12, all P 〈 0. 05） .Conclusion DWI can effectively improve the detection rate of synovial sarcoma, and has higher diagnostic sensitivity,specificity and accuracy, it＇s conducive to the physician for treatment in a timely manner, and worthy of further clinicalpromotion.