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目的探讨In-phase和out-phase图像在脊柱良恶性病变诊断中的应用价值。方法经临床证实的脊柱病变43例,现行常规磁共振扫描,随后进行化学位移成像,分别得到in-phase和out-phase图像,测量并计算信号强度比。43例患者中恶性肿瘤26例(23例转移瘤、2例多发骨髓瘤和1例脊索瘤),7例急性压缩性骨折,4例炎性改变,6例终板炎,43例患者中意外发现血管瘤7例。对良恶性两组病灶的信号强度比进行统计学处理。结果 26例恶性病变,累及椎体病灶与邻近正常椎体相比,in-phase图像上病灶呈稍低或等信号,out-phase图像上呈高信号,恶性病变的SIR为1.23±0.16;17例良性病变in-phase图像上呈低或等信号,out-phase图像上呈等-低信号,SIR 0.74±0.11,良恶性病变信号强度比差异有统计学意义。结论化学位移成像的in-phase和out-phase图像对脊柱良恶性病变的诊断和鉴别诊断有较高临床应用价值。
Objective To investigate the value of In-phase and out-phase images in the diagnosis of benign and malignant spinal lesions. Methods Forty-three patients with clinically confirmed spinal lesions underwent conventional magnetic resonance (MR) scanning. Then chemical shift imaging was performed and the in-phase and out-phase images were obtained respectively. The signal intensity ratio was measured and calculated. Of the 43 patients, 26 were malignant (23 metastases, 2 with multiple myeloma and 1 chordoma), 7 with acute compression fractures, 4 with inflammatory changes, and 6 with endstones Hemangiomas were found in 7 cases. The signal intensity ratio of benign and malignant lesions was statistically analyzed. Results 26 cases of malignant lesions involving vertebral lesions compared with adjacent normal vertebra, in-phase image lesions were slightly lower or equal signal, out-phase images showed high signal, malignant lesions SIR was 1.23 ± 0.16; 17 In benign lesion, the signal of low or equal signal on in-phase image and the signal of equal-low signal on out-phase image, SIR 0.74 ± 0.11, the difference of signal intensity between benign and malignant lesions was statistically significant. Conclusion In-phase and out-phase images of chemical shift imaging have high clinical value in the diagnosis and differential diagnosis of benign and malignant spinal lesions.