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目的探讨不同类型骨转移瘤的背景抑制全身扩散加权成像(DWIBS)的影像特点。方法研究对象包括47例经病理穿刺或临床证实骨转移瘤患者和29名正常志愿者。骨转移病灶按X线或CT表现分为3组:溶骨性转移组、成骨性转移组及混合性转移组。所有研究对象均行DWIBS。正常志愿者及不同类型骨转移瘤表观扩散系数(ADC)值的多组间比较采用单因素方差分析,不同类型骨转移瘤各组间两两比较采用LSD法,P<0.05为差异有统计学意义。不同类型骨转移瘤对比噪声比(CNR)值的多组间比较采用单因素方差分析,LSD法进行两两比较,P<0.05为差异有统计学意义。结果 29名正常志愿者骨骼系统在DWIBS上表现为明显的低信号。22例溶骨性转移者DWIBS上呈明显高信号;15例成骨性转移者DWIBS上呈稍高信号或低信号;10例混合性转移者DWIBS上呈高信号。正常志愿者骨组织的平均ADC值为(74.09±79.07)×10-6mm2/s,溶骨性、成骨性和混合性骨转移瘤的ADC值分别为(1103.47±81.05)×10-6mm2/s,(456.09±86.55)×10-6mm2/s和(816.72±91.20)×10-6mm2/s,溶骨性、成骨性和混合性转移组患者ADC值均明显高于正常志愿者,差异有统计学意义(F=689.156,P<0.05)。各组间进行两两比较,溶骨性转移组ADC值最高,成骨性转移组最低,混合性转移组介于二者之间。溶骨性、成骨性和混合性转移组CNR值分别为(7.04±1.04)%、(1.00±0.34)%,(4.67±0.61)%,各组间两两比较差异均有统计学意义(F=108.493,P<0.05),溶骨性转移组CNR值最高,成骨性转移组最低,混合性转移组介于二者之间。结论 DWIBS是诊断骨转移瘤的有效检查方法,可对溶骨性、成骨性、混合性骨转移瘤的扩散特性进行量化。
Objective To investigate the imaging characteristics of background-suppressed diffusion-weighted whole body imaging (DWIBS) in different types of bone metastases. Methods The study included 47 patients with pathologically confirmed or clinically confirmed bone metastases and 29 normal volunteers. Bone metastasis lesions by X-ray or CT performance is divided into 3 groups: osteolytic metastasis group, osteogenic metastasis group and mixed metastasis group. All subjects underwent DWIBS. One-way ANOVA was used to compare the apparent diffusion coefficient (ADC) values between normal volunteers and different types of bone metastases. LSD was used to compare the different types of bone metastases between groups, and P <0.05 was considered statistically significant Significance of learning. Different groups of bone metastases contrast to noise ratio (CNR) values of multiple groups were compared using one-way ANOVA, LSD method for any comparison, P <0.05 for the difference was statistically significant. Results The skeletal system of 29 normal volunteers showed obvious low signal on DWIBS. Twenty-two patients with osteolytic metastasis showed markedly higher signal intensity on DWIBS; 15 patients had slightly higher signal or lower signal on DWIBS and 10 patients with mixed metastasis showed high signal intensity on DWIBS. The average ADC value of bone tissue in normal volunteers was (74.09 ± 79.07) × 10-6mm2 / s. The ADC values of osteolytic, osteogenic and mixed bone metastases were (1103.47 ± 81.05) × 10-6mm2 / s, (456.09 ± 86.55) × 10-6mm2 / s and (816.72 ± 91.20) × 10-6mm2 / s, respectively. The ADC value of patients with osteolytic, osteogenic and mixed metastasis was significantly higher than that of normal volunteers There was statistical significance (F = 689.156, P <0.05). All the groups were compared with each other, the highest ADC value in the osteolytic metastasis group, the lowest in the osteogenic metastasis group, and the mixed metastasis group was in between. The CNR of osteolytic, osteogenic and mixed metastasis groups were (7.04 ± 1.04)%, (1.00 ± 0.34)% and (4.67 ± 0.61)%, respectively, with significant difference F = 108.493, P <0.05). The highest CNR value in the osteolytic metastasis group was the lowest, and the lowest in the osteogenic metastasis group was between the two. Conclusion DWIBS is an effective method for the diagnosis of bone metastases, which can quantify the diffusion characteristics of osteolytic, osteogenic and mixed bone metastases.