3.0 T MR全身扩散加权成像联合全身冠状位T2-tirm脂肪抑制序列对全身转移瘤筛查临床应用价值

发布时间：2017-12-27 02:07

本文关键词：3.0 T MR全身扩散加权成像联合全身冠状位T2-tirm脂肪抑制序列对全身转移瘤筛查临床应用价值　出处：《临床放射学杂志》2016年07期 　论文类型：期刊论文

【摘要】：目的探讨全身扩散加权成像(WB-DWI)联合全身冠状位T2-tirm脂肪抑制序列对全身转移瘤筛查价值。方法对124例有原发肿瘤病史患者进行WB-DWI及冠状位T2-tirm脂肪抑制序列检查,对上述检查可疑病变部位进行CT或MRI检查(包括增强),分3组进行研究,A组行背景抑制扩散加权成像(DWIBS);B组行DWIBS联合全身冠状位T2-tirm脂肪抑制序列检查;C组,B组+CT或MRI检查。将三者检查结果对比分析,分别计算3种检查方法对病灶显示的敏感度、特异度、准确率,统计B组及C组全身各部位病灶显示数目,并对B组及C组数据做一致性检验分析。结果 B组与C组对病灶准确率均比A组高,A组与B组之间的差异有统计学意义(χ2=16.09,P=0.000),B、C两组间配对卡方kappa一致性检验结果 K=0.841,P=0.0380.05,表明两者诊断一致性很高,但存在差异,全身DWI联合全身MR检查在脊柱、骨盆、股骨上段成骨性及溶骨性转移病灶、肝脏(呼吸均匀者)检出及诊断准确性较高,B组与C组无统计学差异(P0.05),但对脑内、肺、纵隔、盆腔髂血管周围直径10mm较小转移灶、肋骨局部10 mm成骨性转移灶假阴性较高,C组更有优势,B组对肝脏(脓肿、血管瘤等)、肺(肉芽肿、结核球等)、椎体内血管瘤、股骨头坏死、非病理性压缩骨折、多发性骨髓瘤等易造成假阳性,C组准确率更高。结论 WB-DWI联合T2-tirm脂肪抑制序列对全身转移瘤筛查有较高检出率和准确率,同时结合CT或MRI检查能进一步提高病灶检出率和准确率。
[Abstract]:Objective to investigate the value of systemic diffusion weighted imaging (WB-DWI) combined with whole body coronal T2-tirm fat suppression sequence for the screening of whole body metastases. Methods the primary tumor in patients with a history of WB-DWI and coronal T2-tirm fat suppression sequence was performed on 124 cases, CT or MRI to check the suspected lesions (including enhancement), studies were divided into 3 groups, A group for background suppression of diffusion weighted imaging (DWIBS); group B underwent DWIBS combined with systemic coronal T2-tirm fat suppression sequence examination; C group, B group +CT or MRI. The results of the three tests were compared and analyzed. The sensitivity, specificity and accuracy of the 3 inspection methods for lesion display were calculated respectively. The number of lesions in the whole body of B group and C group was counted, and the consistency test and analysis of B group and C group data was done. Results B group and C group focus on the accuracy were higher than A group, there was significant difference between A group and B group (2=16.09, P=0.000), B, C between the two groups paired chi square kappa consistency test results of K=0.841, P=0.0380.05, indicates that the diagnostic consistency is very high, but there are differences. General DWI combined with systemic MR examination in the spine, pelvis, femur bone and osteolytic metastatic lesions, liver (respiratory uniform) detection and diagnostic accuracy, B group and C group had no statistical difference (P0.05), but in the brain, lung, mediastinum, pelvic iliac vessels around the diameter of 10mm small metastases 10 mm, local rib bone metastases high false negative, C group has more advantages, B group of liver (abscess, aneurysm), lung (granuloma, tuberculoma), vertebral hemangioma, femoral head necrosis, non pathological compression fracture, multiple bone marrow tumor causes false positive The C group was more accurate. Conclusion WB-DWI combined with T2-tirm fat suppression sequence has a high detection rate and accuracy for screening of systemic metastases. Combined with CT or MRI examination, it can further improve the detection rate and accuracy of lesions.
【作者单位】：辽宁省鞍山市肿瘤医院放射科;
【分类号】：R445.2;R730.44
【正文快照】： 作者单位:114034辽宁省鞍山市肿瘤医院放射科原发恶性肿瘤容易发生转移,其方式通常有血行转移、淋巴转移、种植及邻近组织直接蔓延等,其中血行转移是癌细胞进入血管随血流转移至远隔部位如肺、肝、骨、脑等处,形成继发性肿瘤。因此选择合理、准确、高效的肿瘤全身转移灶的检查

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