磁共振对脊柱转移瘤放疗后真菌感染的诊断评价

Evaluation of diagnosing effect of magnetic resonance on fungal infection among spinal metastasis tumor patients treated with radiotherapy

目的评价磁共振弥散加权序列(DWI)对脊柱转移瘤放疗后合并真菌感染的诊断效果。方法选取医院2012年1月-2013年3月收治的85例行放疗治疗的脊柱转移瘤患者,使用DWI进行检查,观察合并真菌感染4例与未发生真菌感染26例患者DWI检查结果的差异;采用SPSS13.0进行分析。结果 30例患者共检出35个椎体受到侵犯,共发现病灶41个,均呈高信号;30例患者共有4例合并真菌感染;感染组ADC显著高于非感染组(P<0.05),两组患者骨髓诊断率差异无统计学意义;DWI检出真菌感染4例,确诊3例,敏感性100.0%,特异性75.0%,其敏感性与病理学检查差异无统计学意义。结论 DWI作为一种功能性成像技术,可从定量的角度对脊柱转移瘤放疗后合并真菌感染的判断提供参考信息,从而指导早期临床干预,以改善患者的预后。

OBJECTIVE To evaluate the diagnosing effect of magnetic resonance diffusion ceighted imaging （DWI） on the complicated fungal infections after radiotherapy for spinal metastasis tumor. METHODS A total of 85 cases of spinal metastasis tumor patients treated with radiotherapy in the hospital from Jan 2012 to March 2013 were selected, and examined with DWI; the difference between the DWI test results of the 4 cases of patients complicat- ed with fungal infection and 26 patients without fungal infection were observed; SPSS 13.0 software was adopted for analysis. RESULTS Among the 30 cases of patients, 35 centrums were discovered to be infected, and a total of 41 focus were discovered, which all showed high signal; 4 of the 30 patients suffered complicated fungal infec- tions; the ADC of infection group was significantly higher than that of non-infection group （P〈0.05） and there was no significant difference between the marrow diagnostic rates of the two groups; 4 patients were detected to suffer fungal infections with DWI and 3 patients were confirmed; the sensitivity was 100.0% and the specificity was 75.0% ; there was no significant difference between the sensitivities and pathological examination results. CONCLUSION As a functional imaging technology, DWI can provide reference information for determining the complicated fungal infection caused to spinal metastases tumor patients treated with radiotherapy from a quantita- tive angle, so as to guide early clinical interventions and improve the prognosis of patients.