發(fā)布時(shí)間：2017-12-27 02:07

  本文關(guān)鍵詞：3.0 T MR全身擴(kuò)散加權(quán)成像聯(lián)合全身冠狀位T2-tirm脂肪抑制序列對(duì)全身轉(zhuǎn)移瘤篩查臨床應(yīng)用價(jià)值　出處：《臨床放射學(xué)雜志》2016年07期 　論文類型：期刊論文

  更多相關(guān)文章： . T MR全身擴(kuò)散加權(quán)成像 全身冠狀位T-tirm抑脂序列 轉(zhuǎn)移瘤 篩查

【摘要】：目的探討全身擴(kuò)散加權(quán)成像(WB-DWI)聯(lián)合全身冠狀位T2-tirm脂肪抑制序列對(duì)全身轉(zhuǎn)移瘤篩查價(jià)值。方法對(duì)124例有原發(fā)腫瘤病史患者進(jìn)行WB-DWI及冠狀位T2-tirm脂肪抑制序列檢查,對(duì)上述檢查可疑病變部位進(jìn)行CT或MRI檢查(包括增強(qiáng)),分3組進(jìn)行研究,A組行背景抑制擴(kuò)散加權(quán)成像(DWIBS);B組行DWIBS聯(lián)合全身冠狀位T2-tirm脂肪抑制序列檢查;C組,B組+CT或MRI檢查。將三者檢查結(jié)果對(duì)比分析,分別計(jì)算3種檢查方法對(duì)病灶顯示的敏感度、特異度、準(zhǔn)確率,統(tǒng)計(jì)B組及C組全身各部位病灶顯示數(shù)目,并對(duì)B組及C組數(shù)據(jù)做一致性檢驗(yàn)分析。結(jié)果 B組與C組對(duì)病灶準(zhǔn)確率均比A組高,A組與B組之間的差異有統(tǒng)計(jì)學(xué)意義(χ2=16.09,P=0.000),B、C兩組間配對(duì)卡方kappa一致性檢驗(yàn)結(jié)果 K=0.841,P=0.0380.05,表明兩者診斷一致性很高,但存在差異,全身DWI聯(lián)合全身MR檢查在脊柱、骨盆、股骨上段成骨性及溶骨性轉(zhuǎn)移病灶、肝臟(呼吸均勻者)檢出及診斷準(zhǔn)確性較高,B組與C組無統(tǒng)計(jì)學(xué)差異(P0.05),但對(duì)腦內(nèi)、肺、縱隔、盆腔髂血管周圍直徑10mm較小轉(zhuǎn)移灶、肋骨局部10 mm成骨性轉(zhuǎn)移灶假陰性較高,C組更有優(yōu)勢,B組對(duì)肝臟(膿腫、血管瘤等)、肺(肉芽腫、結(jié)核球等)、椎體內(nèi)血管瘤、股骨頭壞死、非病理性壓縮骨折、多發(fā)性骨髓瘤等易造成假陽性,C組準(zhǔn)確率更高。結(jié)論 WB-DWI聯(lián)合T2-tirm脂肪抑制序列對(duì)全身轉(zhuǎn)移瘤篩查有較高檢出率和準(zhǔn)確率,同時(shí)結(jié)合CT或MRI檢查能進(jìn)一步提高病灶檢出率和準(zhǔn)確率。
[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.
【作者單位】： 遼寧省鞍山市腫瘤醫(yī)院放射科;
【分類號(hào)】：R445.2;R730.44
【正文快照】： 作者單位:114034遼寧省鞍山市腫瘤醫(yī)院放射科原發(fā)惡性腫瘤容易發(fā)生轉(zhuǎn)移,其方式通常有血行轉(zhuǎn)移、淋巴轉(zhuǎn)移、種植及鄰近組織直接蔓延等,其中血行轉(zhuǎn)移是癌細(xì)胞進(jìn)入血管隨血流轉(zhuǎn)移至遠(yuǎn)隔部位如肺、肝、骨、腦等處,形成繼發(fā)性腫瘤。因此選擇合理、準(zhǔn)確、高效的腫瘤全身轉(zhuǎn)移灶的檢查

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