放射性核素骨显像联合磁共振全身弥散加权成像诊断乳腺癌骨转移的价值  

Application value of radionuclide bone imaging combined with magnetic resonance whole-body diffusion-weighted imaging in diagnosis of breast cancer bone metastases

作　　者：张建伟 王洪伟 许科 张杰[3] Jianwei Zhang;Hongwei Wang;Ke Xu;Jie Zhang(Department of Nuclear Medicine,Zhumadian Central Hospital,Zhumadian 463000,China;Department of Radiotherapy,Zhumadian Central Hospital,Zhumadian 463000,China;Department of Nuclear Medicine,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省驻马店市中心医院核医学科,463000 [2]河南省驻马店市中心医院放疗科,463000 [3]河南省人民医院核医学科,郑州450003

出　　处：《中国实用医刊》2021年第21期66-70,共5页Chinese Journal of Practical Medicine

摘　　要：目的分析放射性核素骨显像联合磁共振全身弥散加权成像(WB-DWI)诊断乳腺癌骨转移的价值。方法抽取2019年3月至2021年3月驻马店市中心医院收治的乳腺癌疑似骨转移患者182例,均行放射性核素骨显像检查和WB-DWI检查。以骨髓穿刺结果为"金标准",对比放射性核素骨显像和WB-DWI单独与联合诊断乳腺癌骨转移的诊断结果、诊断效能,对比不同骨组织表观扩散系数(ADC)值,分析放射性核素骨显像和WB-DWI的影像学表现。结果182例乳腺癌疑似骨转移患者中,骨髓穿刺确诊骨转移52例,其中单发骨转移11例,多发骨转移41例;肋骨33例,脊椎20例,胸/锁骨37例,骨盆11例。采用放射性核素骨显像诊断出骨转移51例,非骨转移40例;采用WB-DWI诊断出骨转移50例,非骨转移41例;采用二者联合诊断出骨转移59例,非骨转移32例。放射性核素骨显像联合WB-DWI诊断的灵敏度(96.15%,50/52)高于放射性核素骨显像单独诊断(80.77%,42/52)及WB-DWI单独诊断(82.69%,43/52),P<0.05。放射性核素骨显像联合WB-DWI诊断的漏诊率(3.85%,2/52)低于放射性核素骨显像单独诊断(19.23%,10/52)及WB-DWI单独诊断(17.31%,9/52),P<0.05。肋骨、脊椎、胸/锁骨、骨盆转移病灶的ADC值低于正常骨组织(P<0.05)。结论放射性核素骨显像联合WB-DWI诊断乳腺癌骨转移,可提高诊断灵敏度,降低漏诊率,且骨转移病灶ADC值较低,可为临床诊断鉴别骨转移提供丰富影像学依据。Objective To analyze the application value of radionuclide bone imaging combined with magnetic resonance whole-body diffusion-weighted imaging(WB-DWI)in the diagnosis of breast cancer bone metastases.Methods A total of 182 breast cancer patients suspected with bone metastases who were treated in Zhumadian Central Hospital from March 2019 to March 2021 were selected.All patients underwent radionuclide bone imaging and WB-DWI examination.Taking the results of bone marrow aspiration as the gold standard,the diagnostic results and diagnostic efficacy of radionuclide bone imaging,WB-DWI,and combination of them in the diagnosis of breast cancer bone metastases were compared.The apparent diffusion coefficient(ADC)values of different bone tissues were compared,and the imaging features of radionuclide bone imaging and WB-DWI were analyzed.Results Of 182 breast cancer patients suspected with bone metastases,52 cases were confirmed with bone marrow aspiration,including 11 cases with single bone metastases and 41 cases with multiple bone metastases;33 cases spread into ribs,20 cases spread into vertebrae,37 cases spread into chest/clavicle,and 11 cases spread into pelvis.Fifty-one cases of bone metastasis and 40 cases of non-bone metastasis were diagnosed by radionuclide bone imaging;50 cases of bone metastasis and 41 cases of non-bone metastasis were diagnosed by WB-DWI;while 59 cases of bone metastasis and 32 cases of non-bone metastasis were diagnosed by combination of the two methods.The diagnostic sensitivity of radionuclide bone imaging combined with WB-DWI(96.15%,50/52)was higher than that of radionuclide bone imaging alone(80.77%,42/52)and WB-DWI alone(82.69%,43/52),P<0.05.The rate of missed diagnosis of radionuclide bone imaging combined with WB-DWI(3.85%,2/52)was lower than that of radionuclide bone imaging alone(19.23%,10/52)and WB-DWI alone(17.31%,9/52),P<0.05.The ADC values of metastatic lesions of ribs,spine,chest/clavicle and pelvis were lower than those of normal bone tissue(P<0.05).Conclusions Radionuclide b

关 键 词：乳腺癌 骨转移 放射性核素骨显像 磁共振全身弥散加权成像 诊断效能 表观扩散系数 

分 类 号：R737.9[医药卫生—肿瘤]