磁共振全身弥散加权成像在肿瘤领域中的临床应用  

Clinical application of whole body diffusion-weighted imaging in cancer patients

作　　者：冯平勇[1] 宋振虎[1] 程豪[1] 

机构地区：[1]河北医科大学第二医院医学影像科,河北石家庄050000

出　　处：《临床荟萃》2013年第4期372-376,共5页Clinical Focus

摘　　要：目的评估磁共振全身弥散加权成像(whole Body diffusion-weighted imaging,WB-DWI)在肿瘤患者的应用价值。方法分类对比分析51例肿瘤患者WB-DWI和CT图像中的异常信号和异常密度病灶。结果在实质器官中,CT发现的病变在WB-DWI中均能清晰显示,27处(11.0%)病变WB-DWI能清晰显示而CT却未能显示。在空腔脏器中,WB-DWI发现51处中心型肺癌与CT一致,未能发现57处肺内体积较小的瘤灶。在骨骼系统中,WB-DWI发现异常信号477处,CT仅发现骨骼异常改变309处;其中9例患者有56处WB-DWI异常信号而CT显示正常,数月后CT复查,相应部位均出现骨质破坏。在淋巴系统中,WB-DWI发现异常淋巴结189个,CT发现异常增大淋巴结141个,其中病变位置一致114处。CT图像上25处大于1cm的淋巴结在WB-DWI图像上未显示,而75处(34.7%)小淋巴结在WB-DWI图像上却呈高信号。结论实质脏器和骨骼系统中WB-DWI比CT更多更早发现肿瘤病灶,还可提示异常小淋巴结,并且具有很好的准确性,很高的敏感性。颈部、腹部空腔脏器WB-DWI不易发现体积较小病变。Objective To evaluate the application value of whole body diffusion weighted imaging（WB-DWI） in cancer patients. Methods Abnormal signal and density of WB-DWI and CT images from 51 cancer patients were classified and comparatively analyzed. Results In solid organs,all lesions detected with CT were also revealed with WB- DWI,whereas 27 lesions （11.0G） detected with WB-DWI were not revealed with CT. In hollow organs, WB-DWI revealed 51 central lung cancers,which were consistent with CT,but did not reveal 57 small tumors. In skeletal system, WB-DWI revealed 477 abnormal signal lesions,CT revealed 309 abnormal density lesions. 56 lesions from 9 patients showed WB-DWI abnormal signals, but showed normal density from CT, after some months, CT scan detected bone destruction in corresponding sites. In lymph system, WB-DWI revealed 189 abnormal lymph nodes, CT revealed 141 abnormal increased lymph nodes, 114 of the nodes were detected with both WB-DWI and CT. 25 lymph nodes （diameter〉 1 cm） on CT images were undetected on WB-DWI images,whereas 75 small lymph nodes showed high signals on WB- DWI images. Conclusion WB-DWI can detect more and earlier tumors than CT in solid organs and skeletal system,also hint abnormal smai1 lymph nodes. However,Wt3 DWI has difficultly in detecting small lesions in neck and abdominal hollow organs.

关 键 词：肿瘤 磁共振成像 肿瘤转移 淋巴结 

分 类 号：R73[医药卫生—肿瘤]