磁共振扩散加权成像在肌肉骨骼良恶性病变鉴别诊断中的应用

目的:于肌肉骨骼的良、恶性病变鉴别诊断中应用磁共振扩散加权成像的价值进行分析。方法:对佛山市禅城区中心医院2016年5月至2018年6月诊治肌肉骨骼病变112例患者临床资料加以分析,分为良性组和恶性组,均应用磁共振扩散加权成像进行诊断,对两组鉴别诊断价值进行比对、分析。结果:恶性组的平均ADC值(1.03±0.27)×10^-3mm^2/s比良性组(1.84±0.50)×10^-3mm^2/s低(P<0.05);通过绘制ROC曲线发现:ADC值最佳的诊断阙值是1.38×10^-3mm^2/s,其临界值对于肌骨病变潜在的恶性评估准确度、特异度和敏感度分别为95.39%、95.64%和95.23%,且骶骨软骨内瘤和腰椎转移各3例被误诊成良性病变及椎体血管瘤1例被误诊成恶性病变。结论:于肌肉骨骼的良、恶性病变鉴别诊断中应用磁共振扩散加权成像的价值较高,可较好反应病变弥散特点,且ADC值为良、恶性病变量化指标,值得临床应用。

Application of Diffusion-weighted Magnetic Resonance Imaging in Differential Diagnosis of Benign and Malignant Musculoskeletal Diseases

Objective:To analyze the value of diffusion-weighted imaging in the differential diagnosis of benign and malignant lesions of musculoskeletal.Methods:The clinical data of 112 patients with musculoskeletal lesions from May 2016 to June 2018 were analyzed.The patients were divided into benign group and malignant group.All patients were diagnosed by diffusion-weighted MR imaging,then taken the comparison and analysis.Results:The average ADC value of the malignant group(1.03±0.27)×10^-3mm^2/s was lower than that of the benign group(1.84±0.50)×10^-3mm^2/s(P<0.05).By plotting the ROC curve,it was found that the optimal diagnostic domain value of ADC value is 1.38×10^-3mm^2/s,and the criticality,specificity and sensitivity of the critical value for the potential malignant evaluation of musculoskeletal diseases are 95.39%,95.64%and 95.23%respectively.The 3 cases of tibial cartilage and lumbar vertebrae were misdiagnosed as benign lesions and vertebral hemangioma,One case was misdiagnosed as malignant lesion.Conclusion:The value of magnetic resonance diffusion-weighted imaging in the differential diagnosis of benign and malignant lesions of musculoskeletal was higher,which could better reflect the characteristics of lesion dispersion,and the ADC value was a quantitative indicator of benign and malignant lesions,which was worthy of clinical application.