摘要
目的探讨磁共振扩散加权成像(DWI)对腹膜后不同病理分型原发性脂肪肉瘤的鉴别诊断价值。方法回顾性分析2014年3月至2018年12月青海大学附属医院经手术、病理证实的28例原发性腹膜后脂肪肉瘤患者的临床及影像学资料,所有患者均行DWI检查,b值为0、300、800、1000及1200 s/mm^2,感兴趣区(ROI)范围大小为15~30 mm^2,选取肿瘤的实性部分,每个病灶选取三个ROI并计算其平均表观扩散系数(ADC)值,测量病灶在不同b值下的ADC值及相同b值下不同病理分型腹膜后脂肪肉瘤的ADC值。采用单因素方差分析比较不同病理分型肿瘤之间的ADC值,组间比较采用LSD-t检验。结果28例腹膜后脂肪肉瘤中,11例高分化型,6例黏液型,4例多形性型,3例去分化型,4例混合型。b值取800 s/mm^2病灶显示较好。黏液型与混合型的ADC值差异无统计学意义(P>0.05),余组间差异均有统计学意义(P<0.05)。随着肿瘤分化程度的降低,病灶的ADC值逐渐降低。结论DWI的表现和特征能反映腹膜后脂肪肉瘤的组织学特点,不同病理分型的腹膜后脂肪肉瘤的ADC值不同,随着肿瘤的分化趋于成熟,其ADC值逐渐增高,这对初步对肿瘤的分化及恶性程度的评估提供相应参考。
Objective To investigate the value of diffusion-weighted imaging(DWI)in the differential diagnosis of primary liposarcoma from different pathological types in the retroperitoneum.Methods The clinical and imaging data of 28 patients with primary retroperitoneal liposarcoma confirmed by surgery and pathology from March 2014 to December 2018 in the Qinghai University Affiliated Hospital,were retrospectively analyzed.All patients underwent DWI examination,b value for 0,300,800,1000 and 1200 s/mm^2,the region of interest(ROI)ranged from 15-30 mm^2.The solid part of the tumor was selected.Three ROI were selected for each lesion and the average apparent diffusion coefficient(ADC)was calculated.The ADC value of the lesions under different b values and the ADC values of different pathological types of retroperitoneal liposarcoma were measured.One-way ANOVA was used to compare ADC values between different pathological types of tumors.LSD-t test was used for comparison between groups.Results In 28 cases of retroperitoneal liposarcoma,11 cases of the highly differentiated type,6 cases of the mucinous type,4 cases of the pleomorphic type,3 cases of dedifferentiated type and 4 cases of mixed type.The b value of 800 s/mm2 showed better display of this lesion.There was no significant difference in ADC values between pleomorphic and mixed types(P>0.05),but there was significant difference between the other groups(P<0.05).The increase in the ADC value of the lesion gradually decreases.Conclusion The performance and characteristics of DWI can reflect the histological features of retroperitoneal liposarcoma.The ADC values of different pathological types of retroperitoneal liposarcoma are different.As the tumor differentiation matures,the ADC value decreases gradually.Corresponding references for tumor differentiation and assessment of malignancy are provided.
作者
李伟霞
康东杰
鲍海华
温生宝
LI Weixia;KANG Dongjie;BAO Haihua(Imaging Center,Qinghai University Affiliated Hospital,Xining 810001,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第3期519-523,共5页
Journal of Clinical Radiology
基金
青海省科技厅科技计划项目(编号:2017-SF-158)
作者简介
通讯作者:鲍海华
