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目的探讨肌骨肿瘤中黏液基质对其表观扩散系数(ADC)测定的影响及ADC值鉴别诊断价值的影响。方法对经病理证实的21例富含黏液基质的肌骨肿瘤患者术前行磁共振扩散加权成像(DWI)检查,测量肿瘤实质区ADC值。对照组为29例其他类不含黏液基质肌骨肿瘤。统计分析富含黏液组与对照组间ADC值差异,各组中良、恶性肿瘤间的ADC值差异。结果 (1)富含黏液类肿瘤ADC值均>2.0×10-3mm2/s,平均ADC值为(2.32±0.15)×10-3mm2/s,对照组肿瘤平均ADC值为(1.39±0.37)×10-3mm2/s,两者间差异有统计学意义(t=4.60,P<0.05);(2)富含黏液类肿瘤组中,良、恶性肿瘤平均ADC值分别为(2.10±0.21)×10-3mm2/s、(2.05±0.14)×10-3mm2/s,两者间差异无统计学意义(t=0.68,P>0.05)。(3)不含黏液类肿瘤组中,良、恶性肿瘤平均ADC值分别为(1.41±0.36)×10-3mm2/s、(0.94±0.31)×10-3mm2/s,两者间差异有统计学意义(t=1.72,P<0.05)。结论肌骨肿瘤中的黏液基质成分可使测得的肿瘤ADC值增高且>2.0×10-3mm2/s。在不含黏液基质成分的肌骨肿瘤中,ADC值可用来对良、恶性肿瘤鉴别诊断。
Objective To investigate the effect of mucus matrix on the determination of apparent diffusion coefficient (ADC) in musculoskeletal tumors and the value of differential diagnosis of ADC value. Methods Twenty-one cases of musculoskeletal tumor with mucous matrix confirmed by pathology were examined by diffusion weighted imaging (DWI) before operation, and the ADC value of the tumor parenchyma was measured. The control group consisted of 29 other patients without mucinous stromal musculoskeletal tumors. Statistical analysis of mucus-rich group and control group, the difference between the ADC value, the difference between good and bad tumors in each group ADC value. Results (1) ADC value of mucinous tumors was> 2.0 × 10-3mm2 / s and average ADC value was (2.32 ± 0.15) × 10-3mm2 / s in control group and (1.39 ± 0.37) × The difference between the two groups was statistically significant (t = 4.60, P <0.05). (2) The average ADC values of benign and malignant tumors in the mucinous tumor group were (2.10 ± 0.21) × 10-3mm2 / s, (2.05 ± 0.14) × 10-3mm2 / s, the difference was not statistically significant (t = 0.68, P> 0.05). (3) The average ADC values of benign and malignant tumor in mucinous tumor group were (1.41 ± 0.36) × 10-3mm2 / s and (0.94 ± 0.31) × 10-3mm2 / s, respectively Significance (t = 1.72, P <0.05). Conclusion Musculoskeletal mucus matrix components can increase the measured ADC value of tumors> 2.0 × 10-3mm2 / s. In musculoskeletal tumors without mucinous matrix components, ADC values can be used to differentiate benign and malignant tumors.