磁共振全身弥散加权成像在以周身疼痛为主要症状疾病诊断中的应用价值  

Clinical value of the WB-DWI in the patients with the whole body pain as the main symptom of disease

作　　者：龚婷[1] 贺燕林 马小芳 邓颖[1] 郝宏毅 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏人民医院医学影像科,宁夏银川750002

出　　处：《宁夏医学杂志》2015年第4期322-324,共3页Ningxia Medical Journal

基　　金：宁夏科技攻关资助项目(2011ZYS262)

摘　　要：目的探讨磁共振全身弥散加权成像在以周身疼痛为主要症状的疾病诊断中的临床应用价值。方法通过分析行GE signa HDe 1.5T磁共振全身弥散加权成像21例患者,评价磁共振全身弥散加权成像(WBDWI)在以周身疼痛为主要症状的疾病诊断中的临床应用价值。结果 5例类风湿性关节炎患者均表现为双侧肩关节及双侧膝关节积液,7例多发性肌炎患者3D WB-DWI全身肌肉黑相表现明显不均匀高信号,白相表现为明显不均匀低信号,轴位、矢状位、冠状位均显示清晰,b值为0轴位图像清晰显示全身肌筋膜增厚,肌间隙积液。5例前列腺癌多发骨转移,均为成骨性转移,3D WB-DWI弥散受限不明显,2D轴位、矢状位、冠状位轻度异常信号,结合前列腺增大及前列腺区弥散受限,考虑前列腺癌骨转移。4例多发骨髓瘤患者均表现为病变周围多发高信号肿块,实性部分ADC值2.3×10-3mm2·s-1,以中轴骨、肋骨、肩胛骨为主。结论磁共振全身弥散加权成像在以周身疼痛为主要症状的疾病诊断中具有一定的临床应用价值,可以初步排除肿瘤及其转移性病变,也可以对周身疼痛的结缔组织病患者进行病变筛查。Objective To investigate clinical value of the WB- DWI in the patients with the whole body pain as the main symptom of disease. Methods 21 patients who performed whole body magnetic resonance diffusion weighted imaging( WB- DWI) in our hospital between July 2011 to February 2014 were analyzed. And the clinical value of WB- DWI in the whole body in pain as the main symptom was evaluated. Results Five patients with rheumatoid arthritis showed bilateral shoulders and bilateral knees effusion,and the muscle of seven patients with polymyositis was with non- uniform high signal in 3D WB- DWI black phase and showed non- uniform low signal in 3D WB- DWI white phase,axial,sagittal,coronal show clearly,B value was 0 axial images clearly show the body myofascial thicken,muscle gap effusion. Five cases of multiple bone metastasis of prostate cancer were osteoblastic metastases,3D WB-DWI restricted diffusion was not obvious,2D axial,sagittal,coronal mildly abnormal signal,combined with enlarged prostate and prostate area restricted diffusion maybe prostate cancer bone metastasis. Four cases of multiple myeloma patients showed multiple high signal lesions around the tumor,the ADC value of solid part is 2. 3 × 10- 3mm2· s- 1,mainly to Spine bones,flat bones,ribs,scapula.Conclusion The WB- DWI has certain clinical value in the patients with the whole body pain as the main symptom. On the one hand it may rule out tumors and metastatic lesions,on the other hand,connective tissue disease patients with the whole body pain as the main symptom of disease be screened.

关 键 词：磁共振 全身弥散加权成像 周身疼痛 

分 类 号：R445.2[医药卫生—影像医学与核医学]