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目的 探讨应用动态增强MRI检查技术 ,以肿瘤的廓清率为标准 ,再结合该时间点的信号增加比 ,对肾上腺腺瘤与非腺瘤进行鉴别诊断的临床价值。方法 3 6例共 41个肾上腺肿瘤均先行常规SE序列T1 WI及T2 WI成像 ,再利用屏气快速多层面破坏性梯度回波序列 (fastmultiplanarspoiledgradient-echo ,FMPSPGR)行轴位扫描 ,先平扫 ,再以同样条件行MRI动态增强检查 ,观察病变的增强程度并分别测量肿瘤实质部分的信号值。分别比较腺瘤与非腺瘤的廓清率及信号增加比 ,明确其鉴别诊断价值。结果 延时 5min并以廓清率 2 2 %为阈值时 ,诊断腺瘤的敏感性 74% ,特异性 73 % ,准确性 73 % ;若将延时 5min时肿瘤的廓清率 (2 2 % )与信号增加比(<0 .48)相结合 ,则诊断腺瘤的敏感性、特异性、准确性明显提高 ,分别为 95 %、91%、93 %。结论 利用动态增强检查技术 ,以肿瘤的廓清率为标准 ,再结合该时间点的信号增加比 ,可在最短的时间内提高肾上腺腺瘤与非腺瘤的鉴别诊断水平
Objective To investigate the clinical value of dynamic contrast-enhanced MRI in differential diagnosis of adrenal adenoma and non-adenoma based on the tumor clearance rate, combined with the ratio of signal increase at this time point. Methods Thirty-six adrenal tumors were performed conventional T1-T1 and T2-weighted images of the SE sequence, followed by fast multipolarized polarsgraft-echo (FMPSPGR) MRI dynamic enhanced under the same conditions line inspection to observe the degree of enhancement of the lesion were measured and the real part of the signal value of the tumor. Comparison of adenoma and non-adenoma clearance rate and signal increase ratio, a clear differential diagnostic value. The results of delay 5min and the clearance rate of 22% as the threshold, the diagnosis of adenoma sensitivity 74%, specificity 73%, accuracy 73%; if the delay 5min tumor clearance rate (22%) and The combination of signal enhancement (<0.48) increased the sensitivity, specificity, and accuracy of diagnosis of adenomas by 95%, 91%, and 93%, respectively. Conclusions The dynamic contrast-enhanced detection technique can be used to improve the differential diagnosis between adrenal adenomas and non-adenomas in the shortest time, taking the tumor clearance rate as the standard, combined with the signal increase ratio at this time point