全身弥散加权成像探查肿瘤转移灶的临床应用价值  

Application of whole-body diffusion weighted imaging in detecting tumor metastases

作　　者：韦寅 李瑞雄 林健敏 

机构地区：[1]梧州市人民医院放射科 [2]梧州市人民医院普外科,广西梧州543000

出　　处：《实用放射学杂志》2013年第10期1669-1673,共5页Journal of Practical Radiology

摘　　要：探讨全身弥散加权成像（wholebodymagneticresonancediffusionweightedimagingwithbackgroundbodysignalsuppression,WB-DWIBS）探查全身转移瘤灶的临床应用价值。方法 对72例恶性肿瘤患者行WB-DWIBS扫描,并与常规CT/MRI的影像资料进行比较,分析各自诊断全身转移灶的敏感性与特异性,以及不同部位检出病灶数的差异,比较差异是否有统计学意义。结果 72例恶性肿瘤患者中,依据转移瘤诊断标准,13例无转移,59例被确定转移灶共156处。依据WB-DWIBS和CT/MRI影像共检出原发灶以外转移瘤灶共161处和156处,诊断全身转移瘤灶的灵敏度、特异度、假阴性率、假阳性率、总的符合率分别为90.5%和94.12%、32.5%和52%、9.46%和5.88%、67.5%和48%、78.19%和88.2%;经χ2 检验,WB-DWIBS和CT/MRI的灵敏度、特异度、假阴性率的差异无统计学意义（P〉0.05）,而假阳性率、总的符合率差异有统计学意义（P〈0.05）。对全身脏器转移瘤灶诊断为阴性或阳性数的差异,经χ2 检验,WB-DWIBS及CT/MRI影像差异无统计学意义（P〉0.05）。在全身各部位的转移瘤病灶中,WB-DWIBS对骨骼转移灶的检出率明显高于CT/MRI,对肝及淋巴结转移瘤灶的检出率低于CT/MRI,差异均具有统计学意义（P〈0.05）;而对肺部转移瘤灶的检出率WB-DWIBS与CT/MRI差异无统计学意义（P〉0.05）。结论 WB-DWIBS对全身转移瘤灶探查的敏感度、特异度等与CT/MRI差别不大,但误诊率较大,可成为恶性肿瘤全身转移灶筛查的手段。Objective To evaluate the clinical value of whole body magnetic resonance diffusion weighted imaging with background body signal suppression（WB-DWlBS） in detection of whole body metastases. Methods Seventy two patients with malignant tumors were underwent WB DWlBS and conventional CT/MR examinations. Metastatic lesions were found in WB DWIBS compared to those observed on CT/MR and the sensitivity, specificity and numbers of the detected metastases were statistically analysis. Results 156 metaststic lesions were confirmed in 59 cases of 72 patients. The numbers of the detected metastatic lesions for WB-DWlBS and CT/MRI were 161 and 156, and the sensitivity, specifity, false negative rate, false positive rate, accuracy for WBDWIBS and CT/MRI were 90.5% and 94.12%, 32.5% and 52% , 9.46% and 5.88%, 67.5% and 48%, 78.19% and 88.2%, re spectively. The differences of the sensitivity, specifity and false negative rate were not significant （P〉0.05）, but the differences of false positive rate and accuracy rate were statistically significant （ P〈0.05 ] between WB-DWlBS and CT/MRI. The numbers of the detected metastatic lesions in bone were higher for WB-DWIBS than that for CT/MR1, but lower than CT/MRI in liver and lymph nodes （P〈0.05）. No deference of the numbers of the detected metastatic lesions was found in lung（ P〉0. 05 ）. Conclusion In de tection of metastatic lesions, WB-DWlBS showed similar sensitivity and specifity with CT/MRI, but lower accuracy than CT/MRI. WB DWIBS could be a sensitive and practical method in the screening whole body metastatic lesions.

关 键 词：磁共振成像 弥散加权成像 肿瘤 转移 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.2[医药卫生—诊断学]