骨肿瘤的MR灌注和弥散加权成像研究

Objective:MR-PWI and MR-DWI were supplementary functional methods to differentiate benign from malignant bone tumors.The aim of this study was to assess the diagnostic potential of MR-PWI conjunction with MR-DWI in differentiating benign from malignant bone tumors.Methods:MR-PWI and MR-DWI were performed on 39 patients by using a 1.5 T MR imager.Perfusion imaging was started with GRE-EPI sequence as soon as che bolus administration commenced.With b value as 300 s/mm2,diffusion imaging was performed with SE-EPI sequence.mype of TIC,peak enhancement,steepest slope,signal difference between 2 baselines and ADC were compared between benign and malignant bone tumors.The data were analyzed with soft-ware(SPSS,version 13.0).Subjective overall pefrormance of two techniques was evaluated with Receiver Operating Characteristic(ROC)analysis.Resuits:1.MR-PWI:(1)The Patterns of TIC of most benign bone tumors(17/21)were type Ⅰ and Ⅱ,and all malignant bone tumors were type Ⅲ and Ⅳ.(2)There were significant differences in peak enhancemenl(17.52±2.37 vs.52.42±5.74)%,steepest slope(4.69±2.84 vs.9.63±4.05)%/S and signal difference between 2 baselines(6.87±3.34 vs.31.75±11.0g)% between benign and malignant groups.And their diagnosis accuracy was 82.1%,79.5% and 87.2%,respectively.(3).4 highly vascularized benign bone tumors were mistaken in diagnosis as malignant ones according to their perfusion characteristics.2.MR-DWI:There was significant difference between ADC of benign and malignant groups[(1.86±0.38)vs.(1.44±0.26)] ×10-3 mm2/s when b value was 300 s/mm2.The diagnosis accuracy was 79.5% when ADC value less than 1.63×10-3 mm2/s was considered as malignant ones.3.The diagnosis accuracy of MR-PWI and MR-DWI were 89.7% and 79.5%.respectively.Conclusion:MR-PWI is lhe better valuable technique than MR-DWI in differentiation benign from malignant bone tumors.To suspicious highly vascularized bone tumors.MR-PWI combining with MR-DWI lead to higher diagnosis accuracy.

MR perfusion and diffusion imaging for the diagnosis of benign and malignant bone tumors

Objective  MR-PWI and MR-DWI were supplementary functional methods to differentiate benign from malignant bone tumors. The aim of this study was to assess the diagnostic potential of MR-PWI conjunction with MR-DWI in differentiating benign from malignant bone tumors. Methods  MR-PWI and MR-DWI were performed on 39 patients by using a 1.5 T MR imager. Perfusion imaging was started with GRE-EPI sequence as soon as the bolus administration commenced. With b value as 300 s/mm², diffusion imaging was performed with SE-EPI sequence. Type of TIC, peak enhancement, steepest slope, signal difference between 2 baselines and ADC were compared between benign and malignant bone tumors. The data were analyzed with soft-ware (SPSS, version 13.0). Subjective overall performance of two techniques was evaluated with Receiver Operating Characteristic (ROC) analysis. Results  1. MR-PWI: (1) The Patterns of TIC of most benign bone tumors (17/21) were type I and II, and all malignant bone tumors were type III and IV. (2) There were significant differences in peak enhancement (17.52 ± 2.37 vs. 52.42 ± 5.74) %, steepest slope (4.69 ± 2.84 vs. 9.63 ± 4.05)%/s and signal difference between 2 baselines (6.87 ± 3.34 vs. 31.75 ± 11.09) % between benign and malignant groups. And their diagnosis accuracy was 82.1%, 79.5% and 87.2%, respectively. (3). 4 highly vascularized benign bone tumors were mistaken in diagnosis as malignant ones according to their perfusion characteristics. 2. MR-DWI: There was significant difference between ADC of benign and malignant groups [(1.86 ± 0.38) vs. (1.44 ± 0.26)] ×10⁻³ mm²/s when b value was 300 s/mm2. The diagnosis accuracy was 79.5% when ADC value less than 1.63 × 10⁻³ mm²/s was considered as malignant ones. 3. The diagnosis accuracy of MR-PWI and MR-DWI were 89.7% and 79.5%, respectively. Conclusion  MR-PWI is the better valuable technique than MR-DWI in differentiation benign from malignant bone tumors. To suspicious highly vascularized bone tumors, MR-PWI combining with MR-DWI lead to higher diagnosis accuracy. Supported by a grant from the Natural Sciences Foundation of Liaoning Province (No. 20042140).