应用MR全身扩散加权成像寻找转移瘤原发灶的初步研究  

The preliminary study of searching primary tumors in patients with metastases using MR whole body diffusion weighted imaging

作　　者：顾太富[1] 肖新兰[1] 尹建华[1] 赵海[1] 

机构地区：[1]南昌大学第二附属医院MR室,330006

出　　处：《中华放射学杂志》2008年第12期1279-1282,共4页Chinese Journal of Radiology

摘　　要：目的 探讨MR全身扩散加权成像（DWI）寻找转移瘤患者原发灶的可行性和灵敏度。方法前瞻性分析34例以转移瘤症状就诊，经CT、单光子发射计算机体层成像或MRI发现不明原发灶的转移瘤患者进行全身DWI扫描，分别测量可疑原发灶和转移瘤的表观扩散系数（ADC）值。对经活检或手术病理证实的肺癌患者，应用配对t检验比较原发灶和转移瘤的ADC值。探讨全身DWI对原发灶的检出率和灵敏度。结果通过对34例转移瘤患者全身DWI扫描，发现可疑原发灶24例，其中23例被证实为原发恶性肿瘤，1例可疑原发灶穿刺为良性病变；10例经全身DWI扫描未发现明确原发灶，其中2例经活检明确原发灶，8例经随访6—12个月仍未明确原发灶。确诊的14例肺癌原发灶和转移瘤的平均ADC值分别为（1．24±0．18）×10^-3和（1．16±0．27）×10^-3mm^2／s，差异无统计学意义（t=1．28，P〉0．05）。全身DWI对原发灶的检出率为67．6％（23／34），灵敏度为92．0％（23／25）。结论全身DWI对转移瘤患者寻找原发灶的灵敏度高，可以作为寻找原发灶的筛查方法。Objective To evaluate the availability and sensitivity of MR whole body diffusion weighted imaging （DWI） in searching primary tumors in patients with metastases. Methods Thirty-four patients with symptoms of metastases and unknown primary leasions were scanned by whole body DWI. All the metastases cases were diagnosed by CT, single photon emission computed tomography（SPECT） or MRI. For the cases of suspected primary tumors, apparent diffusion coefficient （ADC） values of the primary and metastatic lesions were measured respectively. For the cases with primary lung cancers and metastases proved by pathology of biopsy or surgical specimens, statistics analysis of ADC values of primary and metastatic lesions was performed with paired samples t-test. The detection rate and sensitivity of this technique for screening primary tumors were evaluated. Results By whole body DWI, 24 cases were found with suspected primary lesions, in which 23 cases were proved primary tumors, and 1 case was proved benign lesion. Ten cases were not identified with primary lesions on whole body DWI, but in which 2 cases were proved primary malignant tumor by biopsy later, and the other 8 cases remained unknown within follow-up of half a year to one year. For the 14 definite cases of lung cancers, the average ADC values of primary and metastatic lesions was （1.24 ±0. 18） × 10^-3 and （ 1.16 ±0. 27） × 10^-3 mm^2/s, respectively （t = 1.28, P 〉 0. 05 ）. The detection rate and sensitivity of whole body DWI for searching primary tumors was 67. 6% （23/34） and 92. 0% （ 23/25 ）, respectively. Condusion The sensitivity of whole body DWI for searching primary tumors is relatively high, and it can be used to search primary tumors in patients with metastases.

关 键 词：磁共振成像 弥散 肿瘤 未知原发灶 肿瘤转移 

分 类 号：R686[医药卫生—骨科学]