磁共振全身弥散加权成像在转移瘤中的应用  

Application of whole body diffusion-weighted imaging in patients with metastatic tumor

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,石家庄市050000

出　　处：《河北医药》2013年第20期3045-3048,共4页Hebei Medical Journal

摘　　要：目的评估磁共振全身弥散加权成像(whole Body diffusion-weighted imaging,WB-DWI)在转移瘤的应用价值。方法分类对比分析50例肿瘤患者WB-DWI和CT图像中的异常信号和异常密度病灶。结果在呼吸系统中,WB-DWI发现51处肺门周围转移瘤,未能发现57处肺内体积较小的瘤灶,而CT均能发现,说明对于肺内转移病灶的检出敏感性差。在腹部实质器官中,WB-DWI发现的88.9%的转移灶CT能够清晰显示,而11.1%的转移灶CT却未能显示;在骨骼系统中,WB-DWI发现474处异常信号,CT仅发现307处骨组织异常改变,其中9例患者有56处骨组织呈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;说明在腹部实质脏器和骨骼系统中WB-DWI比CT更多更早发现肿瘤病灶,并且具有很高的准确性。在淋巴系统中,CT图像上25处大于1 cm的淋巴结在DWI图像上未显示,而CT图像上74处小淋巴结在WB-DWI图像上却呈高信号,部分经病理证实为淋巴转移。结论WB-DWI技术适用于健康查体及恶性肿瘤全身转移的筛查,对于淋巴结定性诊断能够提供有价值的信息。Objective To evaluate the application value of whole body diffusion-weighted imaging （WB-DWI） in patients with metastatic tumor. Methods The abnormal signal and abnormal density focus showed by WB-DWI and CT images in 51 patients with metastatic tumor were classified and comparatively analyzed. Results In respiratory system, WB-DWI revealed 51 metastatic carcinomas around hilar nodes, however 57 smaller carcinomas within lungs were not found, while CT could find these tumor focus, which suggested that the detection sensitivity of WB-DWI was worse for smaller metastatic carcinomas within lungs. In abdominal solid organs,89% of metastases could be detected by WB-DWI,which could also be clearly revealed by CT,but the other 11.1% of them were not showed by CT. In skeletal system, WB-DWI found 477 abnormal signals, however, CT revealed only 309 abnormal changes of bone tissue, in which 56 abnormal signals of bone tissues in 9 patients were showed by WB-DWI ,however, which were showed normal by CT, after several months, CT scan showed bone destruction in corresponding site. The results suggested that WB-DWI could detect raore and earlier tumor focus in solid organ and skeletal system, as compared with CT. In lymph system ,25 lymph nodes （diameter 〉 1 cm） showed by CT were not detected by WB-DWI, however,74 smaller lymph nodes showed by CT were showed high signal on WB-DWI images, part of them was lymph metastasis identified by pathology. Conclusion WB-DWI is suitable for physical examination and screening for metastatic carcinomas in total body ,which can provide valuable information for qualitation diagnosis of lymph node.

关 键 词：磁共振成像 转移瘤 骨转移 淋巴结 

分 类 号：R730.46[医药卫生—肿瘤]