磁共振成像中DKI模型诊断软组织肉瘤的价值及对手术治疗的指导意义

doi:10.7517/issn.1674-0475.221037

摘要/Abstract

摘要： 探讨磁共振成像（MRI）中弥散峰度成像（DKI）模型诊断软组织肉瘤的价值及对手术治疗的指导意义。选取108例软组织肿瘤患者，根据手术病理检查结果分为良性组（45例）与恶性组（63例），均进行DKI模型辅助MRI检查。结果显示，两组肿瘤组织平均弥散峰度（MK）高于肿瘤同层面正常肌肉组织，平均表观弥散系数（MD）低于肿瘤同层面正常肌肉组织，恶性组MK高于良性组，MD低于良性组（P<0.05）。MK与MD联合诊断软组织肉瘤的AUC为0.935，大于单独诊断。MK与软组织肉瘤肿瘤直径、病理分级、侵犯血管/神经/骨质呈正相关，MD与肿瘤直径、病理分级、侵犯血管/神经/骨质呈负相关（P<0.05）。MK高水平的软组织肉瘤患者术后1年复发或转移的相对危险度是低水平患者的6.024倍，MD低水平的软组织肉瘤患者术后1年复发或转移的相对危险度是高水平患者的4.825倍。提示DKI模型辅助MRI诊断软组织肉瘤价值可靠，且与软组织肉瘤特征相关，对手术治疗具有良好指导意义。

关键词: 软组织肉瘤, 磁共振成像, 弥散峰度成像

Abstract: This paper investigated the value of diffusion kurtosis imaging (DKI) model in magnetic resonance imaging (MRI) for the diagnosis of soft tissue sarcoma and its significance in guiding surgical treatment. 108 eight patients with soft tissue tumors were selected and divided into benign group (45 cases) and malignant group (63 cases) according to the results of surgical pathological examination. All patients underwent MRI examination assisted by DKI model. The results showed that the mean diffusion kurtosis (MK) of tumour tissue in both groups was higher than that of normal muscle tissue at the same level of the tumour, and the mean apparent diffusion coefficient (MD) was lower than that of normal muscle tissue at the same level of the tumour, with the MK in the malignant group being higher than that in the benign group and the MD lower than that in the benign group (P<0.05). The AUC of MK and MD combined diagnosis of soft tissue sarcoma was 0.935, which was greater than that of diagnosis alone. MK was positively correlated with tumour diameter, pathological grade and invasion of blood vessels/nerves/bone in soft tissue sarcoma and MD was negatively correlated with tumour diameter, pathological grade and invasion of blood vessels/nerves/bone (P<0.05). The relative risk of 1-year recurrence or metastasis in soft tissue sarcoma patients with high levels of MK was 6.024 times that of patients with low levels, and the relative risk of 1-year recurrence or metastasis in patients with soft tissue sarcoma with low MD level was 4.825 times that of patients with high level. It indicated that the DKI model assisted MRI in diagnosing soft tissue sarcoma was reliable, and was significantly correlated with the pathological characteristics of soft tissue sarcoma, which had a good guiding significance for surgical treatment.

Key words: soft tissue sarcoma, magnetic resonance imaging, diffusion kurtosis imaging

周悦, 齐恩林, 刘树荣, 姜立杰. 磁共振成像中DKI模型诊断软组织肉瘤的价值及对手术治疗的指导意义[J]. 影像科学与光化学, 2023, 41(1): 43-47.

ZHOU Yue, QI Enlin, LIU Shurong, JIANG Lijie. The Value of the DKI Model in Magnetic Resonance Imaging for the Diagnosis of Soft Tissue Sarcoma and Its Guidance for Surgical Treatment[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(1): 43-47.

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