摘要
目的探讨扩散加权成像(DWI)单指数模型、双指数模型及拉伸指数模型的相关参数对于脊柱转移瘤和骨髓瘤鉴别诊断的价值。方法回顾性分析经穿刺或手术病理证实为转移瘤(53例)和骨髓瘤(16例)患者的MR图像,其中DWI图像采取10个b值(0~1500 s/mm2)扫描,用后处理软件生成表观扩散系数(ADC)、真实扩散系数(D)、假性扩散系数(D*)、灌注分数(f)、分布扩散系数(DDC)和拉伸因子(α)。采用独立样本t检验(正态分布)和Mann-Whiney U检验(非正态分布)比较转移瘤和骨髓瘤的各参数值是否有统计学差异,对于两组间有统计学差异的参数值应用受试者工作特征曲线(ROC)分析其鉴别转移瘤和骨髓瘤的诊断效能。将各参数代入Logistic回归模型,筛选出有意义的参数,评估有意义参数的联合诊断效能。结果转移瘤的ADC、D和α值均高于骨髓瘤,D*值低于骨髓瘤,且差异均有统计学意义(P<0.05)。上述参数ROC曲线下面积(AUC)分别为0.661、0.710、0.781、0.743,转移瘤和骨髓瘤的f值和DDC值差异无统计学意义(P>0.05)。Logistic回归模型筛选后进入模型的指标为ADC和α值,模型诊断的正确率为87.0%。结论DWI单指数模型、双指数模型及拉伸指数模型对于脊柱转移瘤和骨髓瘤的鉴别诊断均具有一定价值,以ADC、D和α、D*的诊断效能为佳。ADC联合α后对于二者的鉴别诊断帮助更大。
Objective To explore the value of related parameters in monoexponential,biexponential,and stretched-exponential models of diffusion weight imaging(DWI)in differentiating metastases and myeloma in the spine.Methods 53metastases and 16 myeloma patients underwent MRI with 10 b-values(0-1500 s/mm2).Parameters of ADC,D,D*,f,DDC,andαfrom DWI were calculated.The independent sample t test and the Mann-Whitney U test were used to compare the statistical difference of the parameter values between the two.Receiver operating characteristics(ROC)curve analysis was used to identify the diagnostic efficacy then substituted each parameter into Logistic regression model,identified meaningful parameters,and evaluated their joint diagnostic performance.Results The ADC,D,andαvalues of metastases were higher than those of myeloma,whereas the D*value was lower than that of myeloma,and the difference was significant(P<0.05).The area under the ROC curve for the above parameters was 0.661,0.710,0.781,and 0.743,respectively.There was no significant difference in the f and DDC values(P>0.05).ADC andαwere found to conform to the logistic regression model,and the accuracy was 87.0%.Conclusion The 3 models of DWI have certain values in differentiating metastases and myeloma in spine,and the diagnostic performance of ADC,D,andα,D*was better.Combining ADC withαmay markedly aid in the differential diagnosis of the two.
作者
邢晓颖
张家慧
陈永晔
赵强
房景超
郎宁
袁慧书
XING Xiaoying;ZHANG Jiahui;CHEN Yongye(Department of Radiology,Peking University Third Hospital,Beijing 100191,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第8期1602-1607,共6页
Journal of Clinical Radiology
基金
国家自然科学基金项目(编号:81971578,81701648)
北京大学第三医院临床重点项目(编号:BYSY2018044)
关键词
扩散加权成像
脊柱
转移瘤
骨髓瘤
敏感度和特异度
Diffusion weighted imaging
Spine
Metastases
Myeloma
Sensitivity and specificity
作者简介
通讯作者:袁慧书
