MR全身弥散扫描在多发性骨肿瘤性病变中的应用研究  

Applications of MR whole body DWI in multiple bone tumors

作　　者：刘帅[1] 赵卫东[1] 陈鹏 张红宇[1] 蔡琳[1] 

机构地区：[1]山西医科大学第二医院影像科,山西太原030001 [2]连云港第一人民医院核医学科,江苏连云港222002

出　　处：《中国临床医学影像杂志》2011年第11期790-793,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨MR全身弥散扫描(WB-DWI)在多发骨转移瘤及骨髓瘤鉴别诊断中的应用价值。材料与方法:对57例多发骨肿瘤性病变患者(其中多发骨转移瘤47例,多发骨髓瘤10例)及12例正常志愿者进行WB-DWI检查。选取胸椎、腰椎及髂骨作为研究对象,分析正常志愿者及多发骨肿瘤性病变在WB-DWI上的信号特征,测量其ADC值范围,通过比较ADC值差异探讨WB-DWI在多发骨转移瘤和多发性骨髓瘤鉴别诊断中的价值。同时计算多发骨转移瘤患者通过WB-DWI找到原发灶的阳性病例数的比率。结果:与正常骨质相比,多发骨肿瘤性病变在WB-DWI表现为异常高信号。多发骨转移瘤病灶ADC值高于多发骨髓瘤,且两者的ADC值均明显高于正常骨质(P<0.01)。在多发骨转移瘤患者中,WB-DWI对原发灶的检出率为74.5%(35/47)。结论:通过比较多发骨转移瘤及多发骨髓瘤ADC值的差异,能为两种疾病的鉴别诊断提供一定的参考价值。WB-DWI对原发灶的显示,亦有助于两者的鉴别。Objective： To investigate the value of whole body DWI（WB-DWI） in differential diagnosis of multiple bone metastases and multiple myeloma.Materials and Methods： Fifty-seven cases with multiple bone tumors and 12 cases normal volunteers underwent WB-DWI.Furthermore,the signal characteristic and ADC values of the thoracic,lumbar vertebrae,and llilac bone were analyzed and measured respectively.In addition,the detection frequency for searching primary tumors in patients with multiple osseous metastases was calculated.Results： Multiple osseous tumors demonstrate abnormal high signals on WB-DWI.The ADC value of multiple osseous metastases were higher than that of multiple myeloma.Meanwhile,the ADC value of multiple myeloma and multiple osseous metastases were markedly higher than that of normal bone.The difference was significant in ADC values between multiple myeloma and multiple osseous metastases（P0.01）.The detection frequency for searching primary tumors in patients with multiple osseous metastases was 74.5%（35/47）.Conclusion： Multiple osseous metastases and multiple myeloma can be differentiated by quantitative analysis with ADC value.The WB-DWI can demonstrate primary tumors,which also can help to differentiate multiple osseous metastases and multiple myeloma.

关 键 词：骨肿瘤 肿瘤转移 磁共振成像 弥散 

分 类 号：R738.1[医药卫生—肿瘤] R445.2[医药卫生—临床医学]