DWIBS和全脊柱MR成像对脊柱恶性肿瘤的诊断研究

The diagnostic study of magnetic resonance diffusion weighted imaging with background suppression and whole-spine imaging on detection of spine malignant tumor

目的探讨磁共振背景抑制弥散加权成像(DWIBS)在脊柱恶性肿瘤早期诊断中临床应用价值。方法 60例临床证实为恶性肿瘤患者行全身弥散加权成像检查,并于同一时间对可疑部位行常规磁共振成像检查,必要时增强扫描,诊断结果与临床综合评价结果进行比较,分别比较DWIBS和常规磁共振成像所显示的病例数。结果 60例患者中55例经临床综合评价为脊柱转移瘤。常规MRI联合DWIBS检查的敏感性、特异性、阳性预测值、阴性预测值分别为98.8%、99.4%、95.4%、99.8%。与常规MRI及DWIBS比较,P<0.05有统计学意义。结论 DWIBS在恶性肿瘤脊柱转移瘤早期诊断中具有一定的应用价值,结合常规MRI检查可进一步明确诊断。

Objective To explore the clinical value of whole-body diffusion weighted imaging background suppression （DWIBS） in the early detection of malignant tumor bone metastasis. Methods 60 patients with pathologically validated malignant tumors underwent DWIBS, meanwhile, MRI over suspicious sites was performed, with enhanced scanning given when necessary. The detecting rates of bone metastasis by DWIBS and conventional MRI were compared with final clinical diagnosis. Results Fifty-five patients were diagnosed with spine metastasis clinically. Conventional MRI united DWIBS, the sensitivity, specificity, positive predictive value, negative predictive value was 98.8% , 99.4%, 95.4%, 99.8%, respectively. Compared with the conventional MRI and DWIBS, it considered statistically significant （ P 〈0.05）. Conclusion DWIBS has a certain value on early diagnosis of bone metastatic lesions, and definite diagnosis may be achieved when combining DWIBS with conventional MRI.