【作者】 李晓莉；

【导师】 徐文坚；

【作者基本信息】 青岛大学 ， 影像医学与核医学， 2012， 硕士

【摘要】 目的通过磁共振成像(MRI)观察兔VX2恶性骨肿瘤在骨髓内的浸润范围(瘤缘),并与病理检查结果进行对照,探讨MRI在判断恶性骨肿瘤髓内瘤缘准确性方面的诊断价值。材料和方法选取兔龄、体重相近的新西兰大白兔共25只,于右侧胫骨平台下20mm处植入VX2肉瘤组织块制备成模型兔。待肿瘤破坏骨皮质在周围软组织内形成肿块时行MRI检查,基本成像序列包括SE T1WI、Fat-Sat FSE T2WI、STIR, Fat-Sat SE TIWI+C序列,扫描方位选取矢状位。检查完成后即刻处死模型兔,取标本行病理检查。测量MRI不同序列图像髓内肿瘤纵径远离关节面的最远点到胫骨平台的垂直距离,以此作为肿瘤髓内的瘤缘,并与病理标本进行比较。数据分析采用SPSS17.0统计软件,MRI不同序列图像之间髓内瘤缘测量值的比较采用单因素方差分析,MR不同序列图像髓内瘤缘测量值和病理标本测量值的差值比较分别采用单样本t检验。结果(1)MRI各序列图像在显示肿瘤髓内瘤缘方面,SE TIWI、Fat-Sat FSE T2WI、STIR、Fat-Sat SE TIWI+C序列图像髓内瘤缘的测量值分别为(44.5±10.8)mm、(41.0±9.7)m、(40.7±9.4)mm、(40.3±9.5)mm,四种序列之间的差异无统计学意义(F=0.802,P=0.497>0.05)。(2) SE TIWI、Fat-Sat FSE T2WI、STIR、Fat-Sat SE TIWI+C序列图像髓内瘤缘的测量值和病理标本测量值的差值比较均有统计学意义(t值分别为7.05、6.34、6.45、8.15,P值均<0.05)。(3) SE TIWI、Fat-Sat FSE T2WI、STIR、Fat-Sat SE TlWI+C序列图像髓内瘤缘测量值与病理标本测量值的差值平均值分别为5.2mm、1.7mm、1.5mm、1.0mm。(4)MRI不同序列中,Fat-Sat SE TIWI+C序列图像显示髓内瘤缘的敏感性和特异性分别为88.9%、100%,SE T1WI序列图像显示髓内瘤缘的敏感性和特异性分别为58.3%、44.4%。结论(1)MRI检查在显示恶性肿瘤髓内瘤缘方面具有较高的准确性。(2)MRI不同序列中,Fat-Sat SET1WI+C序列图像显示髓内瘤缘的敏感性和特异性均最高。(3)Fat-Sat SE TIWI+C序列可作为观察肿瘤髓内瘤缘的最佳MR序列。更多还原

【Abstract】 Objective To observe the medullary extent of rabbit VX2malignant bone tumor by the modalities of magnetic resonance imaging (MRI) and pathology so as to investigate the role of MRI in displaying the margin of malignant bone tumor. Materials and methods Twenty-five rabbits were used to erect experimental phantom. The tumor was implanted into the proximate metaphysis of right tibia. Radiological examinations were taken after four to five weeks. The sweep sequences included SE T1WI、Fat-Sat FSE T2WI、STIR、 Fat-Sat SE T1WI+C. After the examination, experimental rabbits would be put to death immediately and taken pathological examination. The medullary margin of tumor was measured from the most distal site to the tibial plateau. Statistical study was processed with statistical software SPSS17.0. Result (1) No statistical significance was found among all series of MRI (F=0.802, P=0.497>0.05). The average of tumor margin in marrow cavity with group SE T1WI、Fat-Sat FSE T2WI、 STIR、Fat-Sat SE T1WI+C were (44.5±10.8)mm、(41.0±9.7)mm、(40.7±9.4)mm、(40.3±9.5)mm, respectively.(2) Statistical significance were found between the difference of tumor margin in group SE T1WI、Fat-Sat FSE T2WI、STIR、Fat-Sat SE T1WI+C and pathological sample(t=7.05、 6.34、6.45、8.15, P<0.05).(3) The sensitivity of group SE T1WI and group Fat-Sat SE T1WI+C was58.3%、88.9%, respectively. The specificity of group SE T1WI and group Fat-Sat SE T1WI+C was44.4%、100%, respectively.(4) The average difference of tumor margin between group SE T1WI and group pathology、group Fat-Sat FSE T2WI and group pathology、 group STIR and group pathology、group Fat-Sat SE T1WI+C and group pathology was5.2mm、1.7mm、1.5mm、1.0mm, respectively. Conclusion (1) The accuracy of MRI in displaying the tumor margin in marrow savity of malignant bone tumor was rational.(2) Both sensitivity and specificity of Fat-Sat SE T1WI+C were highest among all the sequences of MRI.(3) Fat-Sat SE T1WI+C was the optical scanning sequence in displaying the tumor margin of malignant bone tumor.更多还原