van der Woude H J, Verstraete K L, Hogendoorn P C, Taminiau A H, Hermans J, Bloem J L
Department of Radiology, Leiden University Medical Center, The Netherlands.
Radiology. 1998 Sep;208(3):821-8. doi: 10.1148/radiology.208.3.9722866.
To prospectively analyze the value of fast, dynamic, subtraction magnetic resonance (MR) imaging in the characterization of musculoskeletal tumors.
In 175 consecutive patients with a musculoskeletal mass, dynamic contrast-enhanced subtraction MR imaging was performed after administration of 0.1 mmol per kilogram of body weight gadopentetate dimeglumine or gadoteridol. A turbo gradient-echo technique was used, with a temporal resolution of 1-3 seconds. The interval between arterial and early tumor enhancement, the pattern (peripheral or diffuse) of enhancement, and the progression of tumor enhancement, as visualized on time-signal intensity curves, were assessed. MR enhancement features were related to the histopathologic diagnoses.
Differentiation of benign from malignant soft-tissue masses was possible with a sensitivity of 91% and specificity of 72% based on start of enhancement, a sensitivity of 73% and specificity of 97% based on peripheral or diffuse enhancement, and a sensitivity of 86% and specificity of 81% based on progression of enhancement. Benign bone tumors could not be accurately differentiated from malignant bone tumors on the basis of the three defined parameters (sensitivity, 63%-76%; specificity, 50%-76%).
Dynamic, contract-enhanced, subtraction MR images may be useful to differentiate malignant from benign soft-tissue masses.
前瞻性分析快速动态减影磁共振（MR）成像在肌肉骨骼肿瘤特征描述中的价值。
对175例连续性肌肉骨骼肿块患者，静脉注射每千克体重0.1 mmol钆喷酸葡胺或钆特醇后行动态对比增强减影MR成像。采用涡轮梯度回波技术，时间分辨率为1 - 3秒。评估动脉期与肿瘤早期强化之间的时间间隔、强化模式（周边或弥漫性）以及时间 - 信号强度曲线显示的肿瘤强化进展情况。MR强化特征与组织病理学诊断相关。
基于强化开始时间，鉴别良恶性软组织肿块的敏感度为91%，特异度为72%；基于周边或弥漫性强化，敏感度为73%，特异度为97%；基于强化进展情况，敏感度为86%，特异度为81%。基于上述三个确定参数，无法准确鉴别良性骨肿瘤与恶性骨肿瘤（敏感度为63% - 76%；特异度为50% - 76%）。
动态对比增强减影MR图像可能有助于鉴别良恶性软组织肿块。
