DCE-MRI联合DWI检查在良恶性肌骨肿瘤中的诊断价值

Diagnostic value of DCE-MRI combined with DWI examinations in benign and malignant musculoskeletal tumors

目的探讨磁共振动态增强扫描(DCE-MRI)联合弥散加权成像(DWI)检查在良恶性肌骨肿瘤中的诊断价值。方法选取2021年1月至2022年1月98例肌骨肿瘤患者作为研究对象,均接受DCE-MRI、DWI检查。分析DCE-MRI、DWI独立及联合检查在良恶性肌骨肿瘤中的诊断价值。结果经病理检查证实,98例肌骨肿瘤患者中,恶性肿瘤58例(59.18%),良性肿瘤40例(40.82%)。DWI检查中,不同弥散敏感梯度(b)值良性肿瘤的实质部分表观扩散系数(ADC)高于恶性肿瘤(P<0.05)。DCE-MRI检查中,良性肿瘤的容量转移常数(K^(trans))、速率常数(K_(ep))、血管外细胞外间隙容积比(V_(e))均低于恶性肿瘤(P<0.05)。受试者工作特征(ROC)曲线结果显示,DWI检查中,当b=1200 s/mm^(2)时诊断效能最佳,诊断恶性肌骨肿瘤的曲线下面积(AUC)为0.937,灵敏度为89.76%,特异度为88.00%;DCE-MRI检查中,K^(trans)参数诊断效能最佳,诊断恶性肌骨肿瘤的AUC为0.891,灵敏度为89.80%,特异度为83.00%;DWI联合DCE-MRI检查中,1200 s/mm^(2)+K^(trans)参数对恶性肌骨肿瘤诊断的AUC为0.965,灵敏度为82.86%,特异度为92.50%。结论DCE-MRI联合DWI检查在良恶性肌骨肿瘤中的诊断效能较优。

Objective To explore the diagnostic value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)combined with diffusion weighted imaging(DWI)examinations in benign and malignant musculoskeletal tumors.Methods A total of 98 patients with musculoskeletal tumors from January 2021 to January 2022 were selected as the study subjects.All patients underwent DCE-MRI and DWI examinations.The diagnostic value of DCE-MRI,DWI independent and combined examinations in benign and malignant musculoskeletal tumors was analyzed.Results Pathological examination confirmed that among the 98 patients with musculoskeletal tumors,58 cases(59.18%)were malignant tumors and 40 cases(40.82%)were benign tumors.In DWI examination,the apparent diffusion coefficient(ADC)of the parenchymal part of benign tumors with different diffusion sensitive gradient(b)values were higher than those of malignant tumors(P<0.05).In DCE-MRI examination,the volume transfer constant(K^(trans)),rate constant(K_(ep))and extravascular extracellular volume fraction(V_(e))of benign tumors were lower than those of malignant tumors(P<0.05).The results of receiver operating characteristic(ROC)curve showed that in DWI examination,the diagnostic efficiency was the best when b=1200 s/mm^(2),and the areas under curve(AUC)for the diagnosis of malignant musculoskeletal tumors was 0.937,the sensitivity was 89.76%,and the specificity was 88.00%;in the DCE-MRI examination,the diagnostic efficiency of K^(trans) parameter was the best,and the AUC for the diagnosis of malignant musculoskeletal tumors was 0.891,the sensitivity was 89.80%,and the specificity was 83.00%;in DWI combined with DCE-MRI examination,the AUC of 1200 s/mm^(2)+K^(trans) parameter in the diagnosis of malignant musculoskeletal tumors was 0.965,the sensitivity was 82.86%,and the specificity was 92.50%.Conclusion DCE-MRI combined with DWI examinations in benign and malignant musculoskeletal tumors has better diagnostic efficiency.