Ma L D, Frassica F J, McCarthy E F, Bluemke D A, Zerhouni E A
Russell H. Morgan Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
Radiology. 1997 Mar;202(3):739-44. doi: 10.1148/radiology.202.3.9051028.
To assess the diagnostic potential of the rim-to-center differential enhancement ratio in the magnetic resonance (MR) imaging differentiation of benign from malignant musculoskeletal masses.
Dynamic gadolinium-enhanced fast multiplanar spoiled gradient-recalled acquisition in the steady state imaging was performed to evaluate 17 one and soft-tissue masses (10 malignant, seven benign) in 14 patients. The rim-to-center differential enhancement ratio was determined from images at the maximal enhancement rate. The difference in differential enhancement ratios between benign and malignant masses was evaluated and compared with the maximum rate of enhancement for each mass.
Nine of 10 malignant masses showed rapid rim enhancement with delayed central fill-in. This enhancement pattern was absent in benign masses. The average rim-to-center differential enhancement ratio was 0.64 +/- 0.26 for malignant masses and -0.16 +/- 0.33 for benign masses (P < .001). This difference was statistically significant. The average maximum rate of enhancement was 3.41%/sec +/- 2.20 for malignant masses and 2.74%/sec +/- 2.46 for benign masses (P > .05).
Intratumoral enhancement patterns of malignant and benign masses differ because of differences in vascular architecture. These preliminary results suggest that the rim-to-center differential enhancement ratio has potential as an additional parameter for the MR imaging differentiation of indeterminate musculoskeletal masses.
评估边缘至中心差异增强率在磁共振（MR）成像鉴别肌肉骨骼系统良恶性肿块中的诊断潜力。
对14例患者的17个骨与软组织肿块（10个恶性，7个良性）进行动态钆增强快速多平面稳态进动梯度回波成像。在最大增强率时从图像中确定边缘至中心差异增强率。评估并比较良恶性肿块之间差异增强率的差异以及每个肿块的最大增强率。
10个恶性肿块中有9个表现为边缘快速增强伴中心延迟填充。良性肿块中不存在这种增强模式。恶性肿块的平均边缘至中心差异增强率为0.64±0.26，良性肿块为-0.16±0.33（P<.001）。这种差异具有统计学意义。恶性肿块的平均最大增强率为3.41%/秒±2.20，良性肿块为2.74%/秒±2.46（P>.05）。
由于血管结构的差异，良恶性肿块的瘤内增强模式不同。这些初步结果表明，边缘至中心差异增强率有可能作为磁共振成像鉴别不确定肌肉骨骼肿块的一个附加参数。
