| Objective:To investigate the dynamic enhanced magnetic resonance imaging(DCEMRI)quantitative analysis method of the value in the diagnosis of benign and malignant soft tissue tumors.Methods:MRI data collected 40 cases of benign and malignant soft tissue tumors in our hospital from April 2014 to December 2015 comfirmed by surgical pathology or biopsy,which including 20 cases of benign tumors,20 cases of malignant tumor.All these patients underwent routine scanning and dynamic enhanced scanning,then observe and analyze the time signal intensity curve(T-SI),The semi-quantitative parameters which including peak(TTP),maximum rising slope(Slopemax),enhancement ratio(CERmax)and quantitative parameters of bulk transfer constant(Ktrans),reflux rate constant(kep),extravascular extracellular space volume fraction(VE)and plasma volume(VP).Independent samples t test was used in the comparison between benign and malignant soft tissue tumors and draw subjects characteristics curve(ROC curve),the area under the curve were compared,analyzed the best diagnostic threshold detection of benign and malignant soft tissue tumors of various parameters,the sensitivity and specificity.Results: 1,the number in three types T-SI curves(type incremental,platform,outflow type)of Benign soft tissue tumor curve were14,6,0,and in malignant soft tissue tumor were 2,8,10,the curve of benign soft tissue tumor is increasing,malignant soft tissue tumor is mainly platform type,flow type.2,the TTP,Slopemax and CERmax of benign soft tissue tumor were 2.310 ± 1.453 s,0.401 ± 0.223 and 0.245 ± 0.191,malignant soft tissue tumor was 2.576 ± 1.033 s,1.104 ± 0.788,0.492 ± 0.338.The difference was statistically significant between Slopemax and CERmax of two groups(t =-3.841,-2.840,P <0.05),while there was no significant difference between the TTP of two groups.The ROC curve area of Slopemax,CERmax were 0.901,0.794,when the Slopemax=0.613 was the optimal cutoff value,diagnosis of malignant soft tissue tumor specificity and sensitivity respectively 95%,75%,when the CERmax=0.216 was the optimal cutoff value,diagnosis of malignant soft tissue tumor specificity and sensitivity were 95% and 60%.3,the Ktrans,Kep,Ve and Vp in benign soft tissue tumor were(0.0592 + 0.0522)/min,(0.3409 + 0.3499)/min,(0.3266 + 0.3770),(0.1844 + 0.2109);in malignant soft tissue tumors were(0.4363±0.4748)/min,(0.7798±0.4490)/min,(0.5289±0.4852),(0.2041±0.1808).Ktrans and kep values in benign soft tissue tumor were lower than those of the malignant soft tissue tumor,and the difference between the two groups with statistically significant(t =-3.530,-3.448,P < 0.01),Ve and Vp value were no statistically significan between two groups(t =-1.545,-0.318,P > 0.05).ROC curve analysis showed that Ktans ROC curve area of 0.904,when Ktrans=0.106 as the optimal cut-off point,the specificity and sensitivity of malignant soft tissue tumor diagnosis respectively 85% and 95%;area Kep under the ROC curve was 0.816,Kep=0.239 as the optimal cut-off point,the specificity and sensitivity of malignant soft tissue tumor diagnosis respectively 95%,65%.Conclusion: 1,three different types of T-SI curves and semi-quantitative parameters of Slopemax and CERmax in differential diagnosis of benign and malignant soft tissue tumors have significance.2,the quantitative parameter indexes of Ktrans and Kep can further the differential diagnosis of benign and malignant soft tissue tumors,and the diagnosis value is higher than the semi quantitative Slopemax and CERmax.3,the comperehensive anaylasis of semi quantitative and quantitative has greater value in dignosing benign and malignant soft tissue tumors. |
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