Dynamic multi-slice MR T1W perfusion in differential diagnosis of benign and malignant musculoskeletal lesions

Objective To investigate the value of dynamic multi-slice MR T1W perfusion for differential diagnosis of benign and malignant musculoskeletal lesions. Methods A total of 99 cases of benign and malignant musculoskeletal lesions underwent multi-phases multi-slices T1W perfusion scan. Curves of perfusion were described as 4 types. Type of SI-T curves, signal increase in first pass period, maximum slope of SI-T curves and first pass time were statistically compared between benign and malignant lesions. The diagnostic threshold of malignant lesions was determined with ROC, the sensitivity, specificity and accuracy were calculated as well. Results Type of SI-T curves, signal increase in first pass period and maximum slope of SI-T curves were statisticcally different between benign and malignant lesions, most lesions of type Ⅰ SI-T curves were malignant, and most lesions of type Ⅲ or Ⅳ were benign. The average value of signal increase of benign lesions in first pass period was 29.18%, malignant lesions was 73.93% (P0.001). The average value of maximal slope of SI-T curves of benign lesions was 3.49, and malignant lesions was 9.57 (P0.001). ROC analysis showed that with 43.20% signal increase in first pass period as the threshold of malignant, the diagnostic sensitivity, specificity and accuracy was 98.39%,86.49% and 93.94%,respectively. With maximal slope of SI-T curves 5.09 as threshold of malignant, the sensitivity,specificity and accuracy was 96.77%,83.78% and 91.92%, respectively. Conclusion Dynamic multi-slice MR T1W perfusion is valuble in differential diagnosis of benign and malignant musculoskeletal lesion.