3.0 T MRI类PET功能成像与PET/CT在淋巴瘤分期诊断中的对比研究  

The Clinical Study of Diffusion Weighted Whole-Body Imaging with Background Body Signal Suppression( DWIBS)and18F-FDG PET/CT on Lymphoma

作　　者：沈俊杰[1] 张俊祥[1] 陈守康[1] 汪子书[2] 袁超[3] 訾刚[3] 陈自谦[4] 

机构地区：[1]蚌埠医学院第一附属医院放射科,蚌埠医学院医学影像系,233004 [2]蚌埠医学院第一附属医院肿瘤内科,233004 [3]蚌埠医学院第一附属医院核医学科,233004 [4]南京军区福州总医院医学影像科

出　　处：《临床放射学杂志》2017年第5期733-738,共6页Journal of Clinical Radiology

摘　　要：目的探讨3.0 T MRI类PET功能成像(DWIBS)对淋巴瘤诊断分期的临床应用价值。方法搜集本院2014年6月至2016年1月间经穿刺活检确诊为淋巴瘤并排除身体其他部位有原发癌的17例患者,分别进行3.0 T MRI类PET功能成像(DWIBS)和(18)~F-FDG PET/CT检查,图像资料分别由2位经验丰富的磁共振医师和2位核医学诊断医师采用双盲法阅片,按照淋巴瘤Ann Arbor-Cotswald(1989)分期法为标准,分别做出两种影像学检查方法的淋巴瘤分期诊断。比较两种影像学方法的分期诊断结果的符合情况。结果运用DWIBS与PET/CT两种成像方法检查结果的总体差异无统计学意义(P=0.056,<0.05),两种方法检测结果具有较强的一致性(k=0.807);对于结内病变,两种成像方法检测结果的差别无统计学意义(P=0.061,<0.05),检测结果表现为较强吻合度(k=0.852);对于结外病变检测,两种检查方法间的差别有统计学意义(P=0.043,<0.05),检测结果表现为中等程度的吻合度(k=0.718)。结论两者对淋巴瘤的分期诊断无显著性差异,对于淋巴瘤的分期诊断有较高的一致性,是淋巴瘤分期诊断很好检查方法。Objective To study the applied value of diffusion weighted imaging-DWIBS （diffusion weighted imaging with background suppression） in the staging of lymphoma. Methods 17 cases were diagnosed as lymphoma by biopsy and excluded other parts of the body have primary cancer, in the Tumor department of Internal Medicine since June 2014. All seventeen lymphoma patients underwent both DWIBS on 3. OT MR scanner and ISF-FDG PET/CT, extending from the calvaria to the distal femur. The image data was read by 2 experienced magnetic resonance physicians and 2 nuclear medicine physicians with double blind method, then they staged according to the lymphoma Arbor-Cotswald Ann （ 1989 ） staging method as the standard, and compared the coincidence of staging between two kinds of techniques and clinical staging. Re- suits The difference of staging of lymphoma between DWIBS and PET/CT did not have statistical significance （ P = 0. 056, P 〈 0. 05 ）. The results of the two methods had strong consistency（κ = 0. 807 ）. They also had no statistical significance （ P = 0.061, P 〈 0. 05 ） and strong consistency （ κ = 0. 852 ） for the lymph node lesions but extranodal lesions had statistical significance（P=0. 043,P〈0.05）and moderate consistency（κ =0.718）. Conclusion The lymphoma lesions can be displayed clearly on DWIBS, The difference of staging of lymphoma between DWIBS and PET/CT did not have statistical significance and they both had strong coincidence with clinical staging. DWIBS can potentially be used for lesion detection and staging of lymphoma patients.

关 键 词：全身扩散加权成像 正电子发射 计算机断层显像 淋巴瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.44[医药卫生—诊断学] R733.1[医药卫生—临床医学]