论文部分内容阅读
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=0.038<0.05,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(P>0.05),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。
Objective To investigate the value of whole-body diffusion-weighted imaging (WB-DWI) combined with T2-tirm fat suppression sequence in the diagnosis of systemic metastatic tumors. Methods A total of 124 patients with primary tumor history underwent WB-DWI and T2-tirm fat suppression sequence examination. CT or MRI examination (including enhancement) was performed on the suspicious lesion sites in the above three groups. Group A Background Suppressed Diffusion Weighted Imaging (DWIBS); Group B with DWIBS combined with T2-tirm fat suppression sequence; Group C, Group B with CT or MRI. The results of the three tests were compared and analyzed. The sensitivities, specificities and accuracies of the three examinations were calculated. The number of lesions showed in each group of B and C groups was calculated. The data of B and C groups were also consistent Sexual Testing Analysis. Results The accuracy of lesions in group B and group C was higher than that in group A, and the difference between group A and group B was statistically significant (χ2 = 16.09, P = 0.000). The paired chi square kappa was consistent between groups B and C The results of sex test K = 0.841, P = 0.038 <0.05, indicating that the diagnosis of high consistency, but there are differences between the whole body DWI combined with whole body MR examination in the spine, pelvis, upper femur osteogenic and osteolytic lesions, the liver (Respiratory homogeneity) were detected and the accuracy of diagnosis was high. There was no significant difference between group B and group C (P> 0.05), but there was no significant difference in the size of small metastasis around brain, lung, mediastinum and pelvic iliac < In the group of ribs, the false-negative of the bone metastasis was less than 10 mm, and the group C had more advantages. In the group B, the liver (abscess, hemangioma and so on), lung (granuloma, tuberculoma, etc.) Bone necrosis, non-pathological compression fractures, multiple myeloma and other easily lead to false positives, C group higher accuracy. Conclusion The combination of WB-DWI and T2-tirm fat suppression sequence has high detection rate and accuracy for systemic metastatic tumor screening. Combined with CT or MRI examination, the detection rate and accuracy of lesions can be further improved.