CT结合MRI在软组织瘤诊断中的应用

Application of computed tomography combined with magnetic resonance imaging in the diagnosis of soft tissue tumors

目的探讨计算机断层扫描(CT)结合磁共振(MRI)在软组织瘤诊断价值。方法选取2020年1月至2021年12月收治的疑似软组织瘤患者100例,分别进行CT和MRI检查,分析CT、MRI对软组织瘤的表现特征及结合诊断结果、诊断效能。结果软组织瘤CT表现为低密度影,在MRI中表现各异,信号多均匀;MRI中脂肪瘤呈高信号,边界清晰,血管瘤呈血管流空影,淋巴管瘤呈低信号,周围神经鞘瘤呈稍低和稍高信号,韧带样瘤呈等信号和稍高信号;软组织瘤82例,其中脂肪瘤24例、血管瘤23例、淋巴管瘤11例、周围神经鞘瘤15例、韧带样瘤9例;CT结合MRI对软组织瘤的检出率为97%高于CT、MRI检出率86.00%、90.00%(P<0.05);CT、MRI、CT结合MRI诊断软组织瘤的敏感度、特异度分别为93.59%、95.00%、97.59%、72.22%、77.78%、88.89%,CT结合MRI诊断敏感度高于CT诊断敏感度(P<0.05);软组织瘤表观扩散系数(ADC)值高于软组织肉瘤、容量转移常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积比值(Ve)低于软组织肉瘤(P<0.05);CT、ADC、Ktrans、Kep、Ve结合诊断软组织瘤的AUC、特异度最高,分别为0.997、97.6%。结论CT结合MRI对软组织瘤的诊断具有重要价值,有助于软组织瘤的鉴别诊断。

Objective To investigate the value of computed tomography(CT)combined with magnetic resonance imaging(MRI)in the diagnosis of soft tissue tumors.Methods A total of 100 patients with suspected soft tissue tumors admitted to our hospital from January 2020 to December 2021 were selected for CT and MRI examinations.The performance characteristics of CT and MRI on soft tissue tumors,and the diagnostic results and efficacy of their combination were analyzed.Results Soft tissue tumors manifested as low-density shadows on CT scans,which manifested differentially on MRI scans,and most of them were isointensity.On MRI scans,lipomas showed hyperintensity with clear boundary;hemangiomas showed vascular flow shadow;lymphangiomas showed hypointensity;peripheral nerve sheath tumors showed slightly hyperintensity and hypointensity;ligamentoid tumors showed isointensity and hyperintensity.There were 82 soft tissue tumors,including 24 lipomas,23 hemangiomas,11 lymphangiomas,15 peripheral nerve sheath tumors,and 9 ligamentoid tumors.The detection rate of CT combined with MRI for soft tissue tumors was 97%,which was significantly higher than that of the single detection of CT(86.00%)and MRI(90.00%)(P<0.05).The sensitivity of CT,MRI,and their combination in the diagnosis of soft tissue tumors was 93.59%,95.00%,and 97.59%,respectively.The specificity was 72.22%,77.78%,and 88.89%,respectively.The diagnostic sensitivity of CT combined with MRI was significantly higher than that of CT(P<0.05).The apparent diffusion coefficient(ADC)of soft tissue tumors was significantly higher than that of soft tissue sarcomas,while the transfer constant(Ktrans),rate constant(Kep),and the ratio of extravascular to extracellular space volume(Ve)were significantly lower than those of soft tissue sarcomas(P<0.05).The area under the curve(AUC)and specificity of CT combined with ADC,Ktrans,Kep and Ve in the diagnosis of soft tissue tumors were the highest,which were 0.997 and 97.6%,respectively.Conclusion CT combined with MRI is of great value in the diagnosis of soft tissue tumors,which is helpful for the differential diagnosis of soft tissue tumors.