Abstract
目的 探讨应用扩散加权成像(DWI)鉴别良、恶性椎体骨折时的最佳扩散敏感系数值(b值).方法22例椎体压缩性骨折病人分为良性组(10例,因骨质疏松或外伤引起)和恶性组(12例,转移瘤引起),行前瞻性矢状面MR扩散加权成像,用定性评分和定量计算信噪比(SNR)的方法来比较不同b值DWI的质量.二组患者病变椎体的表观扩散系数(ADC)值也做了对比.结果选用的b值越小,DWI的图像质量越清晰,定性评分值越高.在b值为0、100、200、300、400、500、600、700、800s/mm2时,图像SNR分别为22.7±3.4、24.6±3.6、22.2±3.2、19.2±2.6、10.3±2.1、8.8±2.7、6.8±2.7、5.8±1.7和5.8±2.1.各组间差异有非常显著性意义(F=150.13,P＜0.01).良、恶性椎体骨折ADC值的差异也有显著意义(P＜0.05).但在b值为0、100s/mm2的DWI中,4例良性椎体骨折误诊为恶性.结论当DWI应用于鉴别良、恶性椎体骨折时,最佳b值应为300s/mm2左右为宜.b值过大,使噪音本已较明显的DWI质量和SNR进一步降低,影响对病变的分析.b值过小,则降低DWI中水分子的扩散权重,易导致良性椎体骨折假阳性的发生。
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