时间-信号强度曲线在肌骨系统肿块中的诊断价值

The value of time-signal intensity curve in diagnosing musculoskeletal masses

目的 :探讨动态增强MRI时间 信号强度 (SI Time)曲线在肌骨系统肿块中的诊断价值及病理学基础。方法 :对经病理及临床证实的 34例肌骨系统肿块 (1 8例良性 ,1 6例恶性 ) ,采用GRASS序列行动态增强MRI扫描 ,将绘制的SI Time曲线分为 3型 :Ⅰ型 ,快速上升型 ;Ⅱ型 ,缓慢上升型 ;Ⅲ型 ,平坦型。分析良、恶性两组肿块的曲线类型有无差异。结果 :1 6例恶性肿块中 ,1 3例SI Time曲线呈Ⅰ型 ,3例呈Ⅱ型 ,无 1例呈Ⅲ型 ;1 8例良性肿块中 ,5例呈Ⅰ型 ,1 1例呈Ⅱ型 ,2例呈Ⅲ型。SI Time曲线类型在良恶性两组肿块中差异有极显著性意义 (P <0 .0 0 5)。结论 :动态增强MRI时间 信号强度曲线对肌骨系统良恶性肿块具有重要的鉴别诊断价值 ,肿块中央。

Objective:To investigate the value of time signal intensity curve of dynamic contrast enhanced MR imaging and the pathological foundations in diagnosing musculoskeletal masses.Methods:Thirty four musculoskeletal masses confirmed by pathology and clinic (18 benign,16 malignant) were performed with gradient recalled acqusition in the steady state (GRASS) of dynamic contrast enhanced MR imaging.Time signal intensity curve were obtained and classified in three types:curre Ⅰis rapid progression,curve II is gradual progression and curve Ⅲ is no or slight progression.Results:In 16 malignant masses the type of time signal intensity curve was curve Ⅰ for 13 masses,curve Ⅱ for 3 masses and no one for curve Ⅲ,while in 18 benign masses,5 masses were curve Ⅰ,11 were curve Ⅱ and 2 masses were curve Ⅲ.There was an apparent statistical significance for the types of time signal intensity curves between benign musculoskeletal masses and malignant ones( P <0.005).Conclusion:The time signal intensity curve of dynamic contrast enhanced MR imaging plays an important role in differentiating benign from malignant musculoskeletal masses. The different type of curves in periphery and center within the musculoskeletal mass can display the different interstitium pressure and histologic components.