磁共振全身扩散加权成像技术在恶性肿瘤中的应用

The application of whole-body magnetic resonance diffusion-weighted imaging in the malignant tumor

目的评价全身磁共振扩散加权成像(whole-body magneticresonance diffusion-weighted imaging,WB-DWI)在恶性肿瘤疾病中的应用价值。方法20例健康体检者及70例恶性肿瘤患者行WB-DWI检查。70例患者中乳癌34例,1例为术前检查,其余均为术后复查病例;血液系统疾病13例,粒细胞性白血病3例,非何杰金氏淋巴瘤5例,多发性骨髓瘤5例;卵巢癌8例;子宫内膜癌4例;肺癌、大肠癌、胃癌各3例;前列腺癌、食道癌各1例。其中1例非何杰金氏淋巴瘤做了2次WB-DWI检查。原发灶皆经病理组织学确诊,转移瘤的诊断综合组织病理学结果及多种影像学检查而定。对WB-DWI图像、常规MR图像和CT图像行帧对帧对比分析。分别测量正常淋巴结和恶性淋巴结的ADC值,并进行统计学分析。结果WB-DWI检出健康者良性病灶5例,70例患者中,除去37例无转移灶及3例全身骨髓弥漫扩散受限外,30例WB-DWI共检出原发灶以外异常信号136处,其中真阳性、假阳性分别为118处和18处,假阴性15处,检出率为86.8%(118/136)。经x2检验正常淋巴结和恶性淋巴结的ADC值存在显著差异(p<0.05)。结论WB-DWI对恶性肿瘤性疾病的分期、术后随访及疗效评价有一定的价值。

Objective To evaluate the whole-body magnetic resonance diffusion weighted imaging（WB-DWI） in the malignant tumor of the application.Methods 20 healthy individuals and 70 cases of malignant tumor patients were scanned by WB-DWI.In 70 cases of malignant tumor patients,34 cases were breast cancer patients,,in which 1 case for the preoperative examination and the remaining patients were reviewed cases;blood system diseases in 13 cases,three cases of myeloid leukemia,five cases of nonHodgkin＇s lymphoma,multiple myeloma 5 cases;8 cases of ovarian cancer;4 cases of endometrial cancer;lung cancer,colorectal cancer,gastric cancer in 3 cases each;prostate cancer,esophagus in 1 case.1 case of non-Hodgkin＇s lymphoma had been done for 2 WBDWI examinations.The primary tumor were confirmed by histopathology,the diagnosis of metastatic tumor histopathological findings and a variety of integrated imaging examination may be.Of WB-DWI images,conventional MR images and CT images of the frame line frame were compared.Apparent diffusion coefficient（ADC） values of normal lymph nodes and malignant lymph nodes were measured and analyzed statistically.Results WB-DWI detected benign lesions in 5 cases of healthy individuals,70 cases of malignant tumor patients,excluding 37 cases without metastasis and three cases of systemic diffuse proliferation of bone marrow is limited,the 30 cases of WB-DWI were found in abnormal signal other than the primary tumor 136,in which true positive,false-positive,respectively 118 and 18,false-negative 15,the detection rate was 86.8%（118/136）.Chi-square test ADC values of normal lymph nodes and malignant lymph nodes,there were significant differences（p 0.05）.Conclusion WB-DWI has some value,for malignant disease staging,postoperative follow-up and for treatment evaluation.