全身扩散加权成像联合全身MR成像与^(18)F-FDG SPECT-PET/CT对恶性肿瘤转移灶诊断价值的对比研究  

The Clinical Value of Whole-Body MR Imaging Combined with Whole Body Diffusion-Weighted Imaging with Background Body Signal Suppression( DWIBS) for Detecting Metastasis Lesions: Compared with ^(18)F-FDG SPECT-PET /CT

作　　者：张秀莉[1] 李绍东[1] 胡春峰[1] 程广军[1] 路欣[1] 徐凯[1] 

机构地区：[1]徐州医学院附属医院影像科,221000

出　　处：《临床放射学杂志》2013年第10期1514-1519,共6页Journal of Clinical Radiology

摘　　要：目的通过与18F-FDG SPECT-PET/CT作对比,评估全身扩散加权成像(DWIBS)联合全身MRI在恶性肿瘤转移灶中的诊断价值。方法对71例经病理学证实为恶性肿瘤患者行DWIBS和全身MRI,并于3周内行18FFDG SPECT-PET/CT检查。分4组进行研究,即A组:DWIBS;B组:全身MRI;C组:DWIBS联合全身MRI;D组:18F-FDG SPECT-PET/CT。分别计算4组检查方法对病灶显示的敏感性、特异性、准确性、阳性预测值及阴性预测值,并对C组与D组作一致性检验。按部位分别计数C组和D组的全身转移病灶数。结果 C组与D组的诊断准确性较A组与B组高(P<0.05),且C组与D组的符合率较高(P=0.688,K值=0.827)。对肝脏转移灶,C组较D组的检出率高(分别为96%、72%;P<0.05);对肺转移灶,D组较C组的检出率高(分别为82.6%、94.2%;P<0.05);对骨骼转移灶,C组与D组的检出率差异无统计学意义(P>0.05)。C组对脊柱的成骨性转移、脑内转移灶较D组更具优势。结论 DWIBS与全身MRI联合应用技术在恶性肿瘤转移灶显示方面具有较高的准确性,尤其在脊柱成骨性、头颅、肝转移方面较18F-FDG SPECT-PET/CT有优势,而在肺转移方面不如18F-FDG SPECT-PET/CT。Objective To evaluate the value of whole-body MR imaging combined with whole body diffusion-weighted imaging with background body signal suppression（DWIBS） in detecting metastasis lesion. Methods Seventy-one cases with definite malignant tumors underwent DWIBS, whole-body MR imaging, lSF-FDG SPECT-PET/CT within three weeks. The four modalities, included A. （DWIBS） B. （whole-body MR imaging） C. （A and B）D. （lSF-FDG SPECT-PET/CT）, were compared. Methods： The sensitivity, specificity, accuracy, positive predictive value, negative predictive value were evaluated respectively for four modalities and metastases in different parts were counted. Results The accuracy of C and D were significantly higher than accuracy of A or B （ P 〈 0.05 ）. The differences had no statistically significant between C and D（P =0. 688 ,K = 0. 827）. C was found to have a higher detection ratio than D in hepatic metastases （respectively 96% and 72% ;P 〈0.05） but lower in lung metastatic foci （82.6% and 94.2% ;P 〈0.05）. The two modalities had simi- lar performance for bone metastasis detection （ P 〉 0.05 ）. C was actually better for the detection of metastases in spinal os- teogenesis and brain. Conclusion Whole-body MR imaging with DWIBS appear to provide acceptable accuracy and com- parable efficacy for metastases, which is more dominant in detecting spinal osteogenesis, brain and hepatic metastases than ~SF-FDG SPECT-PET/CT, but less useful in lung metastases

关 键 词：扩散加权成像磁共振成像肿瘤 转移灶 18 F-脱氧葡萄糖 单光子-正电子发射型 X线计算机断层 影像 

分 类 号：R817.4[医药卫生—影像医学与核医学]