| [PMID]: | 23151862 |
| [Au] Autor: | Neubauer H; Evangelista L; Hassold N; Winkler B; Schlegel PG; Köstler H; Hahn D; Beer M |
| [Ad] Dirección: | Department of Pediatric Radiology, Institute of Radiology, University of Wuerzburg, Josef-Schneider-Straße 2, Wuerzburg, 97080, Germany. neubauer@roentgen.uni-wuerzburg.de |
| [Ti] Título: | Diffusion-weighted MRI for detection and differentiation of musculoskeletal tumorous and tumor-like lesions in pediatric patients. |
| [So] Fuente: | World J Pediatr;8(4):342-9, 2012 Nov. |
| [Is] ISSN: | 1867-0687 |
| [Cp] País de publicación: | China |
| [La] Idioma: | eng |
| [Ab] Resumen: | BACKGROUND: MRI is the diagnostic mainstay for detection and differentiation of musculoskeletal tumors. However, a projection regarding the biological dignity of lesions based on standard MRI sequences remains difficult and uncertain. This study was undertaken to analyse whether diffusion-weighted MRI (DWI) can distinguish between benign and malignant musculoskeletal tumorous and tumor-like lesions in pediatric patients. METHODS: MR examinations of 44 consecutive pediatric patients (26 girls, mean age 11±6 years) including standard sequences and DWI (b=50/800 s/mm(2)) at 1.5 or 3 Tesla were retrospectively evaluated. The study group contained 10 patients with non-treated malignant tumors and 34 patients with benign lesions. Size, relative signal intensity and apparent diffusion coefficient (ADC, unit ×10(-3) mm(2)/s) were determined in one lesion per patient. RESULTS: Mean ADC was 0.78±0.45×10(-3) mm(2)/s in patients with malignant tumors and 1.71±0.75 ×10(-3) mm(2)/s in patients with benign lesions (P<0.001). Relative operating characteristics (ROC) analysis showed a sensitivity of 90% and a specificity of 91% for malignancy, based on an ADC cut-off value of ≤1.03. On logistic regression, mean ADC and lesion size accounted for 62% of variability in benign vs. malignant tumors. For malignant tumors, the signal intensity ratio was higher on DWI than on T1w post-contrast images (P<0.002). Two cases of local tumor recurrence were diagnosed by DWI only. CONCLUSIONS: DWI shows promising results for determination of biological dignity in musculoskeletal tumors. Mean ADC ≤1.03×10(-3) mm(2)/s is a strong indicator of malignancy at the first diagnosis. The use of DWI for early diagnosis of tumor recurrence in comparison with standard MRI sequences should be evaluated in prospective studies. |
| [Mh] Términos MeSH primario: |
Neoplasias Óseas/diagnóstico
Detección Precóz del Cáncer
Neoplasias de los Músculos/diagnóstico
Recurrencia Local de Neoplasia/diagnóstico
|
| [Mh] Términos MeSH secundario: |
Adolescente
Neoplasias Óseas/patología
Niño
Preescolar
Diagnóstico Diferencial
Imagen de Difusión por Resonancia Magnética
Femenino
Humanos
Lactante
Masculino
Curva ROC
Sarcoma de Ewing/diagnóstico
Adulto Joven
|
| [Pt] Tipo de publicación: | JOURNAL ARTICLE |
| [Em] Mes de ingreso: | 1305 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Fecha de ingreso para procesamiento: | 121115 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1007/s12519-012-0379-8 |
