DWI联合PET/CT对转移性骨肿瘤的影像学表现分析

Study on the imaging manifestations of MRDWI combined with PET/CT for metastatic bone tumors

目的分析转移性骨肿瘤患者单独应用MRDWI、PET/CT以及二者联合应用的影像学诊断价值。方法选取145例本院接诊的转移性骨肿瘤患者,采取MRDWI、PET/CT单独应用以及两种技术联合应用的诊断方案,对比不同b值下MRDWI技术诊断转移性骨肿瘤的差异,对比不同诊断方案的准确率以及诊断效能指标。结果1)相比于b=50 s/mm^(2),b=400 s/mm^(2)、b=800 s/mm^(2)时的信号质量指数、信噪比、信号强度均明显更低,且b=400 s/mm^(2)低于b=800 s/mm^(2)时的数值(P<0.05);2)实质区在b=800 s/mm^(2)时的ADC值明显低于坏死区(P<0.05);3)病理诊断结果显示145例患者共有150个病灶,混合型骨转移、成骨型骨转移病灶分别为110个、40个,MRDWI联合PET/CT检测以及MRDWI单独检测不同转移性骨肿瘤病灶的准确率均明显高于PET/CT单独检测,且联合检测高于MRDWI单独检测准确率,MRDWI的检测时间明显长于PET/CT(P<0.05);4)PET/CT联合MRDWI检测以及MRDWI单独检测的敏感度、特异度、AUC值、阳性预测值、阴性预测值均高于PET/CT单独检测,且两种技术联合检测高于MRDWI单独检测(P<0.001)。结论在转移性骨肿瘤患者病灶组织评估中单独应用MRDWI、PET/CT技术均有一定优势,MRDWI与PET/CT联合检测可有效弥补不足,该方案可以提高诊断率与诊断效能。

Objective To analyze the imaging diagnostic value of MRDWI,PET/CT alone and the combination of the two in patients with metastatic bone tumors.Methods A total of 145 patients with metastatic bone tumor admitted by our hospital were selected to carry out the study.The diagnostic scheme of MRDWI and PET/CT alone and the combined application of the two technologies were adopted to compare the difference of MRDWI in the diagnosis of metastatic bone tumor under different B values.The accuracy and diagnostic efficiency indexes of different diagnostic schemes were compared.Results 1)Compared with b=50 s/mm^(2),the signal quality index,signal-to-noise ratio and signal strength when b=400 s/mm^(2),b=800 s/mm^(2)were significantly lower,and b=400 s/mm^(2)was lower than the value when b=800 s/mm^(2)(P<0.05);2)The ADC value of the parenchymal area at b=800 s/mm^(2)was significantly lower than that of the necrotic area(P<0.05);3)The pathological diagnosis results showed that 145 patients had 150 lesions,110 and 40 mixed bone metastases and osteogenic bone metastases,respectively.MRDWI combined with PET/CT detection and MRDWI alone were more accurate in detecting different metastatic bone tumor lesions than PET/CT.The combined detection was higher than MRDWI alone detection accuracy rate.The detection time of MR DWI was significantly longer than that of PET/CT(P<0.05);4)PET/CT combined MRDWI detection and MRDWI single detection sensitivity,specificity,AUC value,positive predictive value,negative predictive value Both were higher than PET/CT alone,and the combined detection of the two techniques was higher than MRDWI alone(P<0.001).Conclusion Both MRDWI and PET/CT alone have certain advantages in the evaluation of the lesion tissue of patients with metastatic bone tumor,and the combined detection of MRDWI and PET/CT can effectively remedy the deficiency,which can improve the diagnosis rate and diagnostic efficiency.