磁共振全身类PET在恶性肿瘤全身转移灶探查中的应用

Whole-body application of MRI-PET in detecting systemically metastasized malignant tumor

目的探讨磁共振全身类PET在恶性肿瘤全身转移灶探查中的临床应用价值。方法选取2014年7月至2015年9月长庆油田职工医院收治的74例恶性肿瘤患者,分别行磁共振全身类PET检测和CT-MRI检测,比较两种方法检测肿瘤转移病灶的结果。结果 74例恶性肿瘤患者中,67例存在全身不同部位转移,共174处转移瘤。磁共振全身类PET检测发现异常信号灶共170处,转移病灶部位的阳性检出率为98.3%。CT-MRI共检测出异常信号灶152处,转移病灶部位的阳性栓出率为87.3%。两者比较,差异有统计学意义(2=13.47,P=0.00)。磁共振全身类PET对于骨骼和淋巴结转移病灶的阳性检出率分别为100.0%和98.3%,明显高于CT-MRI的阳性检出率(87.7%和86.7%),差异均有统计学意义(均P<0.05);脑、肺、肝和其他部位转移灶的阳性检出率差异无统计学意义(P>0.05)。结论磁共振全身类PET在恶性肿瘤全身转移筛查中有重要的临床意义,而且不需要注射造影剂,无辐射,检测准确率较高且快捷简单,比较适合应用于恶性肿瘤转移的筛查。

Objective To investigate clinical value of whole body（ WB） application of MRI-PET in detecting systemically metastasized malignant tumor. Methods A total of 74 patients with malignant tumor treated in Changqing Oilfield Worker＇s Hospital from June 2014 to September 2015 were selected. Patients underwent WB-MRI-PET and CT-MRI detection respectively. The diagnostic results of tumor metastasis were compared. Results Among 74 patients with malignant tumors,174 metastases were found in 67 patients. A total 170 abnormal signal lesions were found by WB-MRI-PET and 152 abnormal signal lesions were found by CT-MRI. Positive detection rate for metastatic site detected by WB-MRI-PET（ 98. 3%） was significantly higher than that by CT-MRI（ 87. 3%）（ 2= 13. 47,P = 0. 00）. For the site-specific metastases,positive detection rate for the bones and lymph node metastasis detected by WB-MRI-PET（ 100. 0%and 98. 3% respectively） were significantly higher than those by CT-MRI（ 87. 7% and 86. 7% respectively）（ all P〈0. 05）. There was no significant difference in the positive detection rate for metastases in brain,lung,liver and other sites between the two approaches（ P〉0. 05）. Conclusions WB-MRI-PET has important clinical significance with higher detection accuracy and non-essential contrast agent and without radiation. It is suitable for screening malignant tumor metastasis.