目的探讨骨巨细胞瘤的动态增强MRI及MR氢质子波谱的特点及其在骨巨细胞瘤诊断中的作用。方法采用3D fast SPGR序列对21例病理证实的骨巨细胞瘤进行动态增强扫描,并采用点分辨波谱序列（PRESS）对其中12例进行单体素MR氢质子波谱扫描,分别经过工作站处理,得到动态增强扫描时间-信号强度曲线（TIC）及MR氢质子波谱谱线。以手术病理为标准,对骨巨细胞瘤的动态增强扫描时间-信号强度曲线及MR氢质子波谱的特点进行分析。结果21例骨巨细胞瘤的TIC曲线中,19例为Ⅰ型曲线,2例为Ⅱ型曲线;12例MR氢质子波谱的谱线中,9例具有诊断价值,其中有2例出现明显的胆碱峰。结论骨巨细胞瘤的TIC曲线表现为速升下降型,^1H-MRS谱线缺乏胆碱峰或胆碱峰矮小。
目的探讨ADC值在区分肌肉骨骼系统肿瘤良恶性中的作用。方法对33例患有肌肉骨骼系统肿瘤的患者进行MR常规T1加权,T2加权,压脂T2加权检查,以及3D Fast SPGR动态增强成像。MR扩散加权成像采用SS-EPI序列,b值分别取0、700 s/mm^2,在动态增强扫描图像上强化明显的区域作为扩散加权成像图上的感兴趣区,测定肿瘤的ADC值。结果在33例肿瘤中,良性肿瘤为17例,平均ADC值为(1.54±0.35)×10^(-3)mm^2/s,恶性肿瘤共有16例,平均ADC值为(1.45±0.45)×10^(-3)mm^2/s,二者之间无显著性差异(P>0.05)。在33例病例中,共有6例软骨类肿瘤,平均ADC值(1.94±0.51)×10^(-3)mm^2/s;非软骨类肿瘤共有27例,平均ADC值(1.41±0.29)×10^(-3)mm^2/s,二者之间有显著差异(P<0.05)。除1例软骨类肿瘤外,所有软骨类肿瘤的ADC值均大于2.0×10^(-3)mm^2/s。结论以MR动态增强图像来选取DWI图像上肿瘤的感兴趣区(ROI)而测得的ADC值不能区分肌肉骨骼系统肿瘤的良恶性;但是高ADC值(>2.0×10^(-3)mm^2/s)对诊断软骨类肿瘤有一定价值。
We reported a rare case of protoplasmic astrocytoma presenting small muscle atrophy of the right hand as an initial sign.A 39-year-old male was admitted to hospital complaining of chronic muscle atrophy and subtle headache.Electromyography(EMG) showed brief small denervation and no signs of sensory-motor conduction impairment.CT and MRI revealed multiply expansive intracranial lesion in left hemisphere,which was highly suspected of cerebral echinococccus or Balo disease.The patient underwent surgical excision and pathological report was protoplasmic astrocytoma,with glial fibrillary acidic protein(GFAP,+++) of immunohistochemical method.We reviewed clinical features,radiological manifestations and pathology of protoplasmic astrocytoma with medical literature documents.
