Diffusion-weighted MR Imaging for Characterizing Musculoskeletal Lesions
Diffusion-weighted MR Imaging for Characterizing Musculoskeletal Lesions
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DOI：
10.1148/rg.345140190
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发表时间：
2014-09-01
期刊：
影响因子：
5.5
通讯作者：
Fayad, Laura M.
中科院分区：
文献类型：
--
作者：
Subhawong, Ty K.;Jacobs, Michael A.;Fayad, Laura M.
扩散加权（DW）成像是一种功能磁共振（MR）成像技术，可以很容易地纳入常规的非对比材料增强磁共振成像方案，几乎没有额外的扫描时间。DW成像是基于组织微观结构引起的水分子布朗运动的变化。表观扩散系数（ADC）是布朗运动的定量测量：低ADC值通常反映高度细胞微环境，其中扩散受到细胞膜存在的限制，而非细胞区域允许自由扩散并导致ADC值升高。因此，通过ADC映射，可以使用非增强技术获得有关肌肉骨骼病变细胞结构的有用定量信息。局部DW成像在鉴别骨骼和软组织病变良恶性中的作用仍在不断发展；然而，当仔细应用时，这种模式已被证明对肿瘤类型的子集有帮助，例如非粘液样软组织肿瘤。使用DW成像评估骨性和软组织肿瘤的治疗反应的研究表明，更高的ADC值与对细胞毒性治疗的更好反应相关。DW成像在肌肉骨骼病变评估中的成功应用需要熟悉潜在的诊断缺陷，这些缺陷源于技术伪影和与病变细胞无关的混淆因素。需要进一步的研究来评估DW成像- adc制图对肌肉骨骼病变患者的治疗和预后的影响。(c) rsna, 2014
Diffusion-weighted (DW) imaging is a functional magnetic resonance (MR) imaging technique that can readily be incorporated into a routine non-contrast material-enhanced MR imaging protocol with little additional scanning time. DW imaging is based on changes in the Brownian motion of water molecules caused by tissue microstructure. The apparent diffusion coefficient (ADC) is a quantitative measure of Brownian movement: Low ADC values typically reflect highly cellular microenvironments in which diffusion is restricted by the presence of cell membranes, whereas acellular regions allow free diffusion and result in elevated ADC values. Thus, with ADC mapping, one may derive useful quantitative information regarding the cellularity of a musculoskeletal lesion using a nonenhanced technique. The role of localized DW imaging in differentiating malignant from benign osseous and soft-tissue lesions is still evolving; when carefully applied, however, this modality has proved helpful in a subset of tumor types, such as nonmyxoid soft-tissue tumors. Studies of the use of DW imaging in assessing the treatment response of both osseous and soft-tissue tumors have shown that higher ADC values correlate with better response to cytotoxic therapy. Successful application of DW imaging in the evaluation of musculoskeletal lesions requires familiarity with potential diagnostic pitfalls that stem from technical artifacts and confounding factors unrelated to lesion cellularity. Further investigation is needed to evaluate the impact of DW imaging-ADC mapping on management and outcome in patients with musculoskeletal lesions. (C) RSNA, 2014