MRI全景矩阵成像技术在全身骨转移瘤诊断中的价值

The Evaluation of MRI with Total Imaging Matrix for Patients of Bone Metastases

目的探讨全景矩阵成像(TIM)技术对全身骨转移瘤的诊断价值。资料与方法对25例恶性肿瘤患者采用单光子发射计算机断层显像(SPECT)进行全身骨扫描与TIM技术全身MRI扫描,对两种检查方法进行评价比较。结果25例中,MRI-TIM及SPECT共检出23例63个病灶,其中恶性54个、良性9个,TIM正确诊断50个转移瘤病灶,敏感度为93%(50/54),特异度为67%(6/9),阳性预测值为94%(50/53),阴性预测值为60%(6/10)。SPECT正确诊断47个病灶,敏感度为87%(47/54),特异度为56%(5/9),阳性预测值为92%(47/51),阴性预测值为42%(5/12)。两种检查方法的敏感度与特异度之间的差异均无统计学意义(P值分别为0.077和0.643)。全身MRI的诊断准确率为89%(56/63),SPECT的诊断准确率为83%(52/63),两者之间的差异有统计学意义(P=0.000)。结论SPECT与TIM能有效地检出全身骨转移癌灶,但TIM对骨髓病变有较高的空间分辨率,比SPECT的诊断正确率更高。

Objective To discuss the diagnostic value of MRI with total imaging matrix （TIM）for bone metastases. Materials and Methods 25 patients with malignant tumors underwent whole body SPECT as well as MRI with total imaging matrix techniques,the results were compared. Results In 25 patients, 54 malignant and 9 benign bone lesions were detected by MR TIM and SPECT. The sensitivity of TIM techniques was 93% （50/54） , SPECT achieved 87% （47/54 ;P 〉 0.05 ） , specificity was 67% （ 6/9 ） for TIM techniques and 56% （5/9） for SPECT （ P 〉 0.05 ）. negative predictive and positive predictive value were 60% （ 6/10 ） and 94% （ 50/53 ） for TIM techniques, and 42% （ 5/12 ） and 92% （ 47/51 ） for SPECT. Diagnostic accuracy was 89% （ 56/63 ） for MRI and 83% for SPECT（ 52/63 ; P 〈 0. 001 ）, respectively. Conclusion MRI wih TIM techniques and SPECT are useful imaging modalities for a systemic screening for metastatic bone disease. MRI with TIM techniques has higher spatial resolution for bone marrow than that in SPECT.