中国医学影像学杂志
中國醫學影像學雜誌
중국의학영상학잡지
CHINESE JOURNAL OF MEDICAL IMAGING
2015年
5期
373-376,387
,共5页
郎宁%苏敏英%袁慧书%YUAN Huishu
郎寧%囌敏英%袁慧書%YUAN Huishu
랑저%소민영%원혜서%YUAN Huishu
结核,脊柱%脊柱肿瘤%磁共振成像%图像增强%诊断,鉴别
結覈,脊柱%脊柱腫瘤%磁共振成像%圖像增彊%診斷,鑒彆
결핵,척주%척주종류%자공진성상%도상증강%진단,감별
Tuberculosis,spinal%Spinal tumor%Magnetic resonance imaging%Image enhancement%Diagnosis,differential
目的：探讨MR T1WI动态增强成像半定量和定量分析对脊柱结核和脊柱转移瘤的鉴别诊断价值，提高术前影像诊断准确性。资料与方法对24例脊柱结核和22例脊柱转移瘤进行MR T1WI动态增强扫描，对图像后处理分析得到的时间-信号强度曲线、上升期病变信号强度增幅、最大上升线性斜率及应用双室药物代谢动力学分析获得的血管通透性常数（Ktrans）和转运常数（kep）进行比较。结果24例脊柱结核患者中，仅1例（4.2%）呈速降型曲线，12例（50.0%）呈平台型，11例（45.8%）呈持续增强型；22例脊柱转移瘤中，12例（54.5%）呈速降型曲线，7例（31.8%）呈平台型曲线，3例（13.6%）呈持续增强型曲线。脊柱结核组和脊柱转移瘤组信号强度增幅[（198±81）%与（165±60）%]、时间-信号强度曲线最大上升线性斜率[（100±55）%与（111±41）%]和 Ktrans[（0.077±0.036）/min 与（0.077±0.028）/min]差异均无统计学意义（t=1.56、0.76、0，P>0.05）。脊柱结核组kep明显低于转移瘤组[（0.270±0.015）/min与（0.490±0.023）/min，t=38.74，P<0.001]。结论 MR T1WI动态增强成像可以为表现不典型、常规MRI检查不易鉴别的脊柱结核和脊柱转移瘤的鉴别诊断提供一定的参考。
目的：探討MR T1WI動態增彊成像半定量和定量分析對脊柱結覈和脊柱轉移瘤的鑒彆診斷價值，提高術前影像診斷準確性。資料與方法對24例脊柱結覈和22例脊柱轉移瘤進行MR T1WI動態增彊掃描，對圖像後處理分析得到的時間-信號彊度麯線、上升期病變信號彊度增幅、最大上升線性斜率及應用雙室藥物代謝動力學分析穫得的血管通透性常數（Ktrans）和轉運常數（kep）進行比較。結果24例脊柱結覈患者中，僅1例（4.2%）呈速降型麯線，12例（50.0%）呈平檯型，11例（45.8%）呈持續增彊型；22例脊柱轉移瘤中，12例（54.5%）呈速降型麯線，7例（31.8%）呈平檯型麯線，3例（13.6%）呈持續增彊型麯線。脊柱結覈組和脊柱轉移瘤組信號彊度增幅[（198±81）%與（165±60）%]、時間-信號彊度麯線最大上升線性斜率[（100±55）%與（111±41）%]和 Ktrans[（0.077±0.036）/min 與（0.077±0.028）/min]差異均無統計學意義（t=1.56、0.76、0，P>0.05）。脊柱結覈組kep明顯低于轉移瘤組[（0.270±0.015）/min與（0.490±0.023）/min，t=38.74，P<0.001]。結論 MR T1WI動態增彊成像可以為錶現不典型、常規MRI檢查不易鑒彆的脊柱結覈和脊柱轉移瘤的鑒彆診斷提供一定的參攷。
목적：탐토MR T1WI동태증강성상반정량화정량분석대척주결핵화척주전이류적감별진단개치，제고술전영상진단준학성。자료여방법대24례척주결핵화22례척주전이류진행MR T1WI동태증강소묘，대도상후처리분석득도적시간-신호강도곡선、상승기병변신호강도증폭、최대상승선성사솔급응용쌍실약물대사동역학분석획득적혈관통투성상수（Ktrans）화전운상수（kep）진행비교。결과24례척주결핵환자중，부1례（4.2%）정속강형곡선，12례（50.0%）정평태형，11례（45.8%）정지속증강형；22례척주전이류중，12례（54.5%）정속강형곡선，7례（31.8%）정평태형곡선，3례（13.6%）정지속증강형곡선。척주결핵조화척주전이류조신호강도증폭[（198±81）%여（165±60）%]、시간-신호강도곡선최대상승선성사솔[（100±55）%여（111±41）%]화 Ktrans[（0.077±0.036）/min 여（0.077±0.028）/min]차이균무통계학의의（t=1.56、0.76、0，P>0.05）。척주결핵조kep명현저우전이류조[（0.270±0.015）/min여（0.490±0.023）/min，t=38.74，P<0.001]。결론 MR T1WI동태증강성상가이위표현불전형、상규MRI검사불역감별적척주결핵화척주전이류적감별진단제공일정적삼고。
PurposeTo investigate the significance of dynamic contrast-enhanced magnetic resonance imaging in differential diagnosis of spinal tuberculosis and metastatic cancer.Materials and Methods DCE-MRI was performed in 46 patients, including 24 cases of TB and 22 cases of metastatic cancer. The characteristic DCE parameters including time-signal intensity curve, signal intensity amplification, and maximum slope were calculated. The two-compartmental pharmacokinetic model was used to obtain Ktrans and kep.Results Of 24 cases of TB, only 1 case (4.2%) showed the wash-out kinetic pattern, 12 cases (50.0%) showed the plateau pattern, and 11 cases (45.8%) showed the persistent enhancing pattern. Of 22 cases of metastatic cancers, 12 cases (54.5%) showed wash-out kinetic pattern, 7 cases (31.8%) showed plateau pattern, and 3 cases (13.6%) showed persistent enhancing pattern. Compared to the metastatic cancer group, the TB group was not statistic different in peak signal enhancement [(198±81)%vs. (165±60)%, P>0.05], maximum slope [(100±55)%vs. (111±41)%,P>0.05] and Ktrans[(0.077±0.036)/minvs. (0.077±0.028)/min,P>0.05]. The TB group had a lower kep when compared with the metastatic cancer group [(0.270±0.015)/minvs. (0.490±0.230)/min,t=38.74,P<0.001]. Conclusion DCE-MRI may provide additional information for differential diagnosis when the manifestations of spinal TB and metastasis were similar or atypical.
