全身扩散加权成像在骨转移瘤的临床应用探讨  

The study of whole body diffusion weighted imaging application in bone metastasis

作　　者：吴旭[1] 马常英[1] 王绍武[2] 

机构地区：[1]齐齐哈尔市第一医院放疔科,161002 [2]大连医科大学附属第一医院放射科

出　　处：《中华放射学杂志》2009年第9期986-989,共4页Chinese Journal of Radiology

摘　　要：目的探讨全身DWI（WB—DWI）查找骨转移瘤的应用价值。方法选取健康志愿者10名；搜集骨转移瘤患者35例，同时行WB-DWI与ECT全身骨骼检查，将2种方法的不同显示结果行χ^2检验。结果（1）背景被充分抑制，脂肪、肌肉、血管、肝脏呈现与背景信号相同的等信号，正常骨骼呈等或稍低信号，一些腺体、小淋巴结、肾脏等为中等信号，脾脏、睾丸、脑组织呈低信号；膀胱、胆囊因“T2穿透效应”呈低信号。骨转移瘤呈大小不等、结节状明显低信号。（2）35例骨转移瘤患者中4例WB—DWI与ECT显示一致，31例两种方法显示转移瘤数量不吻合。WB—DWI显示的病灶分布：颅骨1个，胸肋骨46个，肩胛骨3个，四肢骨4个，椎体83个，骨盆骨36个，共173个；ECT显示病灶分布：颅骨2个，胸肋骨62个，肩胛骨7个，四肢骨9个，椎体64个，骨盆骨19个，共163个。WB—DWI对胸骨肋骨转移瘤显示率为ECT的74％，ECT对椎体和骨盆骨转移瘤显示率分别为WB-DWI的77％、53％。两者差异有统计学意义（P〈0．05），表明不同部位的骨转移瘤在WB-DWI与ECT图像上显示的总体概率分布不同。结论WB—DWI是查找骨转移瘤有效的影像技术。Objective To evaluate the value of whole-body DWI （WB-DWI）in bone metastasis. Methods WB-DWI was performed on 10 healthy volunteers and 35 patients with bone metastasis. WB-DWI and ECT was performed in all 35 patients to detect bone metastasis and compared the result between two methods with a chi-square test, P 〈 0. 05. Results （ 1 ） Background tissue was suppressed in WB-DWI, fat, muscle, vessels and liver appeared the same as background. Skeleton showed medium or slightly lower signal. Lymph nodes, some glandular organs, kidneys were showed medium signal. Spleen, testicle, brain tissue were low signal, bladder, gallbladder were depicted as low signal because of ＂T2 through＂effect. Bone metastasis were multitude and inequality of size, punctiform, nodosity, or column low intensity. （2） Concordance between WB-DWI and ECT was seen only in 4 case, while in total WB-DWI displayed 1 bone metastasis on skull, 46 on rib and sternum, 3 on scapula, 4 on extremities, 83 on vertebral, 36 on pelvic bone. ECT showed 2 bone metastasis on skull, 62 on rib and sternum, 7 on scapula, 9 on extremities, 64 on vertebral, 19 on pelvic bone. WB-DWI was recognizable for 74% bone metastasis on rib and sternum, ECT was 77% ,53% for vertebral and pelvic bone（P 〈0. 05）. Total distribution probability varied for metastasis of different location. Conclusion WB-DWI was a sensitive method for screening bone metastasis.

关 键 词：肿瘤转移 骨肿瘤 磁共振成像 弥散 体层摄影术 发射型计算机 

分 类 号：R686[医药卫生—骨科学]