DCE-MRI对原发性骨肉瘤恶性程度的评估价值

目的:探讨动态增强曲线类型及动态增强参数对原发性骨肉瘤恶性程度评判的临床价值.方法:对51例经病理证实的骨肉瘤患者行动态增强MR扫描,采用Mean Curve分析软件得到时间-信号强度曲线(TIC)、早期动态增强的斜率值(Slope)和边缘-中心向心强化程度比值(Rrim-center).使用多个独立样本的非参数检验比较高、低度恶性骨肉瘤的TIC类型分布;采用两个独立样本秩和检验比较高、低度恶性骨肉瘤的动态增强参数;采用多个独立样本非参数检验比较不同曲线类型的骨肉瘤的动态增强参数.结果:高、低度恶性骨肉瘤的TIC类型的分布差异具有统计学意义(x2=22.364,P=0.000).高度恶性骨肉瘤的Slope值和Rrim-center值均高于低度恶性骨肉瘤,差异有统计学意义(Z=-5.159,P=0.000;Z=-5.284,P=0.000).Ⅰ型、Ⅱ型、Ⅲ型TIC曲线的Slope值和Rrim-center值逐渐减小,差异有统计学意义(x2=24.453,P=0.000;x2=25.246,P=0.000).结论:TIC类型、动态增强参数值可评价原发性骨肉瘤的恶性程度.

The value of dynamic contrast-enhanced MRI in evaluating the degree of malignancy of osteosarcoma

Objective:The purpose of this study was to explore the clinical value of time-signal intensity curve (TIC) types and parameters of dynamic contrast-enhanced MRI (DCE-MRI) in evaluating the degree of malignancy of osteosarcoma.Methods:51 patients with osteosarcoma confirmed by pathology were examined by DCE-MRI scan.TIC type,slope and rim-center were obtained by mean curve software.TIC types was analyzed by rank sum test of a number of independent samples;two independent samples rank sum was used to analyze DCE-MRI parameters of low-grade and high-grade osteosarcoma;the DCE-MRI parameters of three different curve types were compared by use of rank sum test of a number of independent samples.The P value ＜0.05 was considered significant.Results:The x2 value of TIC type between high-grade and low-grade osteosarcoma was 22.364,with P=0.000 (P＜0.05),which was significantly different.Both slope and rimcenter values of highly malignant osteosarcoma were higher than those of the low-grade ones.The Z and P value of slope and rim-center values between the high-grade and low-grade malignant osteosarcoma were-5.159,-5.284 and 0.000,0.000 (P＜0.05),indicating a significant statistical difference.The slope and rim-center values of TIC type Ⅰ,Ⅱ,and Ⅲ decreased,the x2 value and P value of slope and rim-center value of different TIC types were 24.453,25.246 and 0.000,0.000 (P＜0.05),which indicated significant statistical difference.Conclusion:TIC types and DCE-MRI parameters can evaluate the degree of malignancy of osteosarcoma.