Lim Hyun Kyong, Jee Won-Hee, Jung Joon-Yong, Paek Mun Young, Kim InSeong, Jung Chan-Kwon, Chung Yang-Guk
1 Department of Radiology, Seoul St. Mary's Hospital, School of Medicine, The Catholic University of Korea , Seoul St. Mary's Hospital, School of Medicine, The Catholic University of Korea , Seoul , Republic of Korea.
2 Department of Diagnostic Imaging, Siemens Healthcare Korea , Siemens Healthcare Korea , Seoul , Republic of Korea.
Br J Radiol. 2018 Feb;91(1082):20170636. doi: 10.1259/bjr.20170636. Epub 2017 Dec 15.
To evaluate the intravoxel incoherent motion (IVIM) diffusion-weighted (DW) MRI for differentiating between benign and malignant musculoskeletal tumours at 3 T.
65 patients with treatment-naïve musculoskeletal tumours (47 malignant and 23 benign lesions) who underwent 3 T MRI including IVIM DW imaging were included. IVIM-derived parameters included pure diffusion coefficient (D), perfusion related incoherent microcirculation (D*, pseudodiffusion coefficient), and perfusion fraction (f). IVIM parameters and mono-exponential apparent diffusion coefficient (ADC) were retrospectively measured by two independent musculoskeletal radiologists.
D and ADC values of malignant tumours (923 ± 360, 965 ± 353 µm s, respectively) were significantly lower than those of benign tumours (1668 ± 546, 1689 ± 526 µm s) (p < 0.001). F values of malignant tumours (9.6%) were significantly higher than those of benign tumours (7.2%) (p = 0.021), whereas D* values showed no significant difference (p > 0.05). The area under the receiver operating characteristic (ROC) curve of D, ADC and f were 0.874, 0.880 and 0.671, respectively. Using cut-off values of D and ADC of 1200 µm s, the sensitivity, specificity and accuracy were 92, 83, 89%, 92, 87 and 90%, respectively.
D and ADC may be more accurate and reliable for differentiation of malignant from benign musculoskeletal tumours than f and D* at 3 T IVIM DW imaging. Advances in knowledge: Among IVIM-derived parameters, D is more accurate and reliable in differentiating malignant from benign musculoskeletal tumours than f and D* at 3.0T IVIM DW imaging. There was no significant difference in the diagnostic performance of D and ADC.
评估体素内不相干运动（IVIM）扩散加权（DW）磁共振成像（MRI）在3T场强下鉴别肌肉骨骼肿瘤良恶性的价值。
纳入65例未经治疗的肌肉骨骼肿瘤患者（47例恶性病变和23例良性病变），均接受了包括IVIM DW成像的3T MRI检查。IVIM衍生参数包括纯扩散系数（D）、灌注相关的不相干微循环（D*，伪扩散系数）和灌注分数（f）。由两名独立的肌肉骨骼放射科医生对IVIM参数和单指数表观扩散系数（ADC）进行回顾性测量。
恶性肿瘤的D值和ADC值（分别为923±360、965±353μm²/s）显著低于良性肿瘤（1668±546、1689±526μm²/s）（p<0.001）。恶性肿瘤的f值（9.6%）显著高于良性肿瘤（7.2%）（p = 0.021），而D*值无显著差异（p>0.05）。D、ADC和f的受试者操作特征（ROC）曲线下面积分别为0.874、0.880和0.671。采用D和ADC的截断值为1200μm²/s时，敏感性、特异性和准确性分别为92%、83%、89%，92%、87%和90%。
在3T IVIM DW成像中，D和ADC在鉴别肌肉骨骼肿瘤良恶性方面可能比f和D更准确可靠。知识进展：在IVIM衍生参数中，在3.0T IVIM DW成像中，D在鉴别肌肉骨骼肿瘤良恶性方面比f和D更准确可靠。D和ADC的诊断性能无显著差异。
