磁共振全身弥散技术在恶性肿瘤筛查中的临床应用

Clinical application of whole-body diffusion-weighted magnetic resonance imaging in screening malignant tumour

目的评价磁共振全身弥散成像(WB-DWI)在恶性肿瘤筛查中的临床应用价值。方法回顾分析75例恶性肿瘤患者的WB-DWI与对照检查资料。对照检查包括常规MRI和/或CT检查,4例另行PET检查。通过按部位逐一与对照检查比较,评估WB-DWI对瘤灶检出的敏感性及特异性。结果 75例中,WB-DWI和/或对照检查显示瘤灶和可疑病灶的部位达174个。WB-DWI对瘤灶检出的整体敏感性及特异性分别为84.1%和96.7%;淋巴结、骨骼、肺和肝胆胰脾等恶性肿瘤常见转移部位的敏感性分别为93.2%、96.4%、78.6%和90.9%,特异性则分别为77.4%、83.0%、100%和98.1%。结论 WB-DWI对恶性肿瘤的检出具有较高准确性,通过技术改进以及与常规CT和MRI扫描的取长补短,有望在恶性肿瘤临床分期方面取代PET检查。

Objective To evaluate the clinical value of whole body diffusion weighted imaging（WB-DWI）in screening malignant turnout. Methods 75 cases with malignant tumour were retrospectively analyzed. All the cases underwent WBDWI and contrast examinations, which included conventional MRI and/or CT scan. Additionally, 4 cases were examined with PET. All the images of WB-DWI had been compared with those of contrast examination region by region before the sensitivity and specificity of WB-DWI in detection of malignant lesions were analyzed. Results The malignant or suspected lesions which were located in 174 regions of all 75 cases were detected by WB-DWI and contrast examinations. The overall sensitivity and specificity of WB DWI were 84.1% and 96.7% ,respectively. In the common regions of malignant metastases, such as lymph node; skeleton; lung; liver, gallbladder, pancreas and spleen, the sensitivity was 93.2%, 96.4%, 78.6 %and 90.9 %, and the specificity was 77.4 %, 83.0 %, 100% and 98.1 %, respectively. Conclusion WB-DWI is a highly accurate method in screening malignant turnout, and is hopeful to replace PET in the clinical staging of malignant tumor through technology improvement and complementary examinations such as conventional CT and MRI scanning.