摘要
背景与目的:随着临床上晚期肿瘤病例的增多,为了解治疗前、后全身转移瘤的大小及数量变化的实际情况,以往多采用分部位进行CT和(或)MR扫描,少部分有条件的患者采用PET检查,但这些方法可能存在过多地暴露于射线、检查时间过长及经济负担过重等问题。因此,我们探讨磁共振的全身弥散加权成像(whole body diffusion weighted imaging,WBDWI)方法对肿瘤及转移灶的检出准确性及其临床应用的可行性。方法:对68例临床已发现原发肿瘤及多个转移灶或发现多个肿瘤病灶,但原发灶不明确的患者进行WBDWI检查,其中男性49例;女性19例。平均年龄61岁。68例均与CT和(或)MRI的检查结果进行比较,其中17例与PET的检查结果相比较。对病灶的检出率,以病灶长径大小分为:<1cm,≥1～<2cm,≥2～<3cm及≥3cm以上4组进行计数分析,同时,对不同部位间的病灶检出情况进行分析。结果:WBDWI对4组病灶的检出率分别为30%、78%、96%及100%。在各个部位的敏感性和准确性中以骨骼最高。对位于肺部小于1cm的病灶和位于颈部、盆腔小于2cm的淋巴结的诊断存在一定困难。结论:WBDWI对大范围的肿瘤病灶筛查是安全、简便、有效和经济的检查新方法。随着技术参数的进一步完善,WBDWI在发现和诊断全身多发肿瘤方面,具有良好的发展潜力。因此,本技术有望作为一种新的、效果好于PET的全身检查技术。
Background and purpose： With the increased number of advanced tumors, it is important to evaluate the actual pre- and post-treatment changes in metastatic diseases, such as tumor size and tumor quantity. Previously, CT and/or MRI scan were usually applied, only a few patients could pay for PET（positron emition tomography）.But there were several problems we should face, including redundantly exposure to radiation, too long verification time and heavy financial burden. Therefore we evaluated the application of whole body diffusion weighted imaging in diagnosing of tumor and metastatic tumor. Methods： sixty-eight patients （49 male,19 female, age from 29 to 84 years with mean age of 61 years） with a variety of tumors were investigated by combined CT and/or MRI scan, seventeen patients were compared with positron emition tomograph（PET）.All tumors were classified into four groups ,according to longest diameter of 〈1 cm, ≥ 1-〈2 cm, ≥ 2-〈3 cm and ≥ 3 cm. At the same time, the positive detection rates between different parts of the lesions were analyzed. Results： The detection rate of the four groups were 30%, 78%, 96% and 100%, respectively. The skeletal system had the highest sensitivity and accuracy in every part of body. There was difficulty in diagnosing lung cancer with longest diameter less than 1 cm as well as tumors located in neck and pelvic with longest diameter less than 2 cm. Conclusion： Whole body diffusion weighted imaging is secure, convenient, effective and economic for screening wide-ranging tumor focus. After improvement of parameters, WBDWI could be as a new effective whole body examination technique.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2009年第2期145-148,共4页
China Oncology
基金
厦门市科技计划项目(No:3502Z20074017)
关键词
全身
弥散
肿瘤
磁共振成像
whole body
diffusion
neoplasm
magnetic resonance imaging
