The Application Of DWI And DCE-MRI In Differentiating Benign Musculoskeletal Masses From Malignant Ones

The Application of DWI and DCE-MRI in Differentiating Benign Musculoskeletal Masses from Malignant OnesObjective To assess the diagnostic potential of DWI and DCE-MRI in differentiating benign from malignant musculoskeletal masses.Methods1.62 patients with musculoskeletal diseases (29 cases of benign and 33 cases of malignant) were selected, which have complete MRI data. Routine MR examination and DWI was performed on 62 patients and DCE-MRI was performed on 47 patients (22 cases of benign and 25 cases of malignant) using Siemens Sonata 1.5T MR scanner. All the patients were divided into benign and malignant groups by pathology.2. ADC value is measured on DWI and SEE, Slope value, DER and TIC type were gained on DCE-MRI. Receiver operating characteristic (ROC) curve was used to select the threshold to calculate the sensitivity, specificity and accuracy. Statistical analyses were completed by using SPSS 17.0.Results1. In 62 Cases, the ADC values of two groups were (179.95±21.21)×10-5mm2/s, (112.48±16.08)×10-5mm2/s (p<0.05).Using 115.43×10-5mm2/s as the threshold, the diagnostic sensitivity, specificity, and accuracy were 69.7%,93.1%,80.65%, respectively.2. In 47 patients,Ⅲcurve was found in 25 cases(malignant for 24 and benign for 1),Ⅱcurve in 15 cases(malignant for 1 and benign for 14) andⅠcurve in 7 cases(all were benign). AsⅢcurve was considered malignant andⅠ,Ⅱcurve were regarded as benign, the diagnostic accuracy of TIC type was 95.74%.3. SEE, Slope value and DER in benign and malignant group were 194.70±23.58,327.3±24.21(p<0.05);1.1469±0.1678%/s,3.0501±0.6069%/s(p<0.05); 0.1636±0.03970,0.2244±0.0362(p>0.05), respectively. Using 227.7 as the threshold, the diagnostic sensitivity, specificity, and accuracy of SEE were 80%,70%,75.56%. And the diagnostic sensitivity, specificity, and accuracy of Slope value were 96.0%, 72.7%,85.11% using 1.2923%/s as the threshold.Conclusion1. DWI is valuable in the differential diagnosis of benign and malignant musculoskeletal lesions.2. In all the parameters of DCE-MRI, DER was not valuable in differentiating benign and malignant musculoskeletal lesions. SEE, Slope value and type in the TIC to TIC types was the most valuable parameter in DCE-MRI.3. In general, DCE-MRI was more valuable than DWI in differentiating benign from malignant musculoskeletal masses.4. To highly suspicious musculoskeletal lesions, DCE-MRI combining with DWI lead to higher diagnostic accuracy.