目的:同相(IP)和反相(OP)化学位移成像(CSI)是评估骨骼病变的有用技术。当前的研究确定了从纵向(冠状或矢状)序列获得的测量结果与从轴向序列获得的测量结果存在显着差异的频率。
方法:在肌肉骨骼肉瘤和脊柱肿瘤学服务转诊的96例连续患者中进行了CSI,以评估可能的骨肿瘤,这是标准肿瘤方案的一部分,该方案包括涡轮自旋回波和反转恢复序列。对于脊柱病变,CSI是在矢状和轴向平面获得的,而对于冠状和轴向平面中的所有其他部位。
结果:该研究包括49名(51.0%)男性和47名(49.0%)女性,平均年龄为42.4岁(范围2-91岁)。在四个案例中,评估了2个单独的病变,共100个病变.根据典型的影像学特征(n=57)或组织学(n=43),22个病变(22%)被归类为非肿瘤性,44(44%)为良性肿瘤,6(6%)为中级肿瘤,28(28%)为恶性肿瘤。在9-14%的病例中出现显著差异,使得在纵向平面中病变被分类为含脂肪(%SI下降>20-25%),而在轴向平面中病变被分类为脂肪替代(%SI下降<20-25%),反之亦然。然而,这种差异对整体诊断准确性没有明显影响,纵向平面为79%,轴向平面为75-80%。
结论:基于成像平面,9-14%的病例在CSI测量中出现显著差异,但对诊断准确性没有显著影响。
OBJECTIVE: In-phase and opposed-phase chemical shift imaging (CSI) is a useful technique for assessing skeletal lesions. This study determined the frequency of significant differences in measurements obtained from longitudinal (coronal or sagittal) sequences to those obtained from axial sequences.
METHODS: Chemical shift imaging was undertaken in 96 consecutive patients referred from the Musculoskeletal Sarcoma and Spinal Oncology services for assessment of possible bone tumours as part of a standard tumour protocol, which included turbo spin echo and inversion recovery sequences. For spinal lesions, CSI was obtained in the sagittal and axial planes, while for all other sites, it was obtained in the coronal and axial planes.
RESULTS: The study included 49 (51.0%) males and 47 (49.0%) females with mean age 42.4 years (range 2-91 years). In 4 cases, 2 individual lesions were assessed, making a total of 100 lesions. Based on typical imaging features (n = 57) or histology (n = 43), 22 lesions (22%) were classified as non-neoplastic, 44 (44%) as benign neoplasms, 6 (6%) as intermediate-grade neoplasms, and 28 (28%) as malignant neoplasms. A significant discrepancy, wherein a lesion was classified as fat-containing (% SI drop >20%-25%) in the longitudinal plane, while in the axial plane it was classified as fat-replacing (% SI drop <20%-25%), or vice versa, occurred in 9%-14% of cases. However, this discrepancy had no appreciable effect on overall diagnostic accuracy, which was calculated at 79% for the longitudinal plane and 75%-80% for the axial plane.
CONCLUSIONS: Significant differences in CSI measurements occur in 9%-14% of cases based on imaging plane, but with no significant effect on diagnostic accuracy.
CONCLUSIONS: Radiologists should be aware that CSI measurements in different planes appear to have significant differences in up to 14% of lesions. However, diagnostic accuracy does not seem to be significantly affected.