快速全身扩散加权磁共振扫描在肿瘤性病变中的初步应用  

Preliminary Application of Whole Body MR Diffusion-weighted Imaging in Tumors

作　　者：黄娟[1] 管永靖[1] 陈克敏[1] 凌华威[1] 魏来[1] 

机构地区：[1]交通大学医学院附属瑞金医院放射科,上海200025

出　　处：《临床放射学杂志》2009年第8期1113-1117,共5页Journal of Clinical Radiology

基　　金：上海市重点学科建设项目资助(编号:S30203)

摘　　要：目的探讨快速全身磁共振扩散加权成像(whole body diffusion-weighted imaging,WB-DWI)技术在肿瘤性病变中的初步应用价值。资料与方法使用WB-DWIBS扫描脉冲序列(b=800s/mm2),对24例肿瘤患者进行回顾性分析,经背景抑制三维-最大密度投影(3 dimensional-maximum intensity projection,3D-MIP)重组及黑白翻转技术观察病变,与同位素骨扫描(single proton emission computed tomography,SPECT)结果对照。对可疑病变行表观扩散系数(apparent diffusion coefficient,ADC)值测量,并评判肿瘤患者病变进展状况及治疗后疗效。结果采用b=800s/mm2的DWI获得的原始图像经背景抑制(background suppression,BS)、3D-MIP重组及黑白翻转技术,得到类正电子发射体层摄影(positron emission tomography,PET)图像,经过三维图像旋转结合原始横断面图像及可疑病变ADC值测定,肿瘤性病变在DWI上呈清楚的高信号。WB-DWI检出全身病变的敏感性高于SPECT。4例肿瘤患者于化疗后随访复查全身DWI,均提示原发病灶缩小或减少。结论WB-DWI有助于病变的定位及鉴别,可初步对肿瘤患者全身受累状况及疗效进行评估。Objective To evaluate application values of WB-DWI （whole body diffusion-weighted imaging） in tumors. Materials and Methods The whole body diffusion - weighted imaging （ b = 800 s/mm^2 ） in 24 patients with tumors were retrospectively analyzed （8 multiple myeloma, 5 non-Hodgkin lymphoma, 1 acute lymphoblastic leukemia, 4 lung cancer, 2 breast cancer, 2 kidney cancer, 1 bladder cancer, 1 osteosarcoma）. The lesions were displayed by background suppression rebuilding with 3D-MIP（3 dimensional maximum intensity projection） and technique with reverse black and white. The resuhs were compared with SPECT （single proton emission computed tomography）. Apparent diffusion coefficient（ADC） of the suspicious lesions were measured. The tumor progression and the curative effect of the patients can be evaluated through these methods. Results The diffusion-weighted images rebuilt by 3D-MIP and the technique with reverse black and white have good background suppression effect. Most of the tumors which were hyperintensivc on DWI were displayed clearly in the ima- ges alike PET. WB-DWI has higher sensitivity in detecting the whole body＇ s lesions than SPECT. The lesions in 4 patients with tumors decreased in the WB-DWI after chemotherapy. Conclusion WB-DWI contributes to the location and identification of the lesions. It can evaluate the general conditions and the curative effect of the patients preliminarily.

关 键 词：扩散加权成像 表观扩散系数 肿瘤 筛查 磁共振成像 

分 类 号：R730.4[医药卫生—肿瘤]