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背景与目的:背景抑制扩散加权成像(diffusion-weighted whole-body imaging with background body signal suppression,DWIBS)是一种可用于全身检查的MR成像技术,可以较好地显示淋巴结及骨骼系统病变,其成像效果与PET类似。本研究旨在探讨DWIBS与核素骨扫描成像在骨转移性病变诊断中的临床应用价值。方法:36例经手术或穿刺病理证实为恶性肿瘤的患者行DWIBS及核素骨扫描检查,比较两者检出骨转移的情况,采用χ2检验,P<0.05为差异有统计学意义。结果:36例恶性肿瘤患者中,30例(共165处)发生骨转移,其中DWIBS检出26例(143处),核素骨扫描检出23例(132处),两者在检出骨转移方面差异无统计学意义(χ2=1.002,P=0.506)。DWIBS及核素骨扫描诊断骨转移的灵敏度、阳性预测值、准确度较为接近,分别为86.7%、96.3%、86.1%和76.7%、88.5%、72.2%;DWIBS诊断骨转移的特异度、阴性预测值高于核素骨扫描,分别为83.3%、55.6%和50.0%、30.0%。分析DWIBS和核素骨扫描检出骨转移的部位,两者的检出率分别为86.7%(143/165)、80.0%(132/165),差异无统计学意义(χ2=2.640,P=0.104);但DWIBS在检出骨盆及四肢长骨转移方面优于核素骨扫描,且两者差异均有统计学意义(χ2=6.783和7.636,P=0.023和0.016)。结论:运用DWIBS扫描技术可有效检出骨转移性病灶,且与核素骨扫描具有较好的一致性,有望在临床上推广应用。
BACKGROUND & OBJECTIVE: Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) is a MR imaging technique that can be used for whole body examination. It can display the lymph node and skeletal system diseases well, The effect is similar to PET. This study aimed to investigate the clinical value of DWIBS and radionuclide bone scan imaging in the diagnosis of bone metastatic lesions. Methods: Thirty-six patients with pathologically confirmed malignant tumors underwent DWIBS and radionuclide bone scan. The bone metastases were detected byχ2 test. P <0.05 was considered statistically significant. Results: Of the 36 patients with malignant tumors, bone metastases occurred in 30 of 165 patients, including 26 cases (143) of DWIBS and 23 (132) cases of radionuclide bone scan. There was no significant difference in metastasis (χ2 = 1.002, P = 0.506). The sensitivity, positive predictive value and accuracy of DWIBS and radionuclide scintigraphy were 86.7%, 96.3%, 86.1% and 76.7%, 88.5% and 72.2%, respectively. The specificity and negative rate of DWIBS in diagnosis of bone metastasis The predictive value was higher than that of radionuclide bone scan, which were 83.3%, 55.6% and 50.0%, 30.0% respectively. The detection rates of bone metastases by DWIBS and radionuclide bone scan were 86.7% (143/165) and 80.0% (132/165), respectively, with no significant difference (χ2 = 2.640, P = 0.104). However, DWIBS was superior to radionuclide bone scintigraphy in the detection of pelvic and long bone metastases (both χ2 = 6.783 and 7.636, P = 0.023 and 0.016). Conclusion: DWIBS scanning technique can effectively detect bone metastatic lesions, and has good consistency with the radionuclide bone scan, which is expected to be widely applied in clinic.