CAJ | 학술논문

目的探讨MR全身扩散加权成像(DWI)寻找转移瘤患者原发灶的可行性和灵敏度.方法前瞻性分析34例以转移瘤症状就诊,经CT、单光子发射计算机体层成像或MRI发现不明原发灶的转移瘤患者进行全身DWI扫描,分别测量可疑原发灶和转移瘤的表观扩散系数(ADC)值.对经活检或手术病理证实的肺癌患者,应用配对t检验比较原发灶和转移瘤的ADC值.探讨全身DWI对原发灶的检出率和灵敏度.结果通过对34例转移瘤患者全身DWI扫描,发现可疑原发灶24例,其中23例被证实为原发恶性肿瘤,1例可疑原发灶穿刺为良性病变;10例经全身DWI扫描未发现明确原发灶,其中2例经活检明确原发灶,8例经随访6～12个月仍未明确原发灶.确诊的14例肺癌原发灶和转移瘤的平均ADC值分别为(1.24±0.18)×10-3和(1.16±0.27)×103mm2/s,差异无统计学意义(t=1.28,P>0.05).全身DWI对原发灶的检出率为67.6%(23/34),灵敏度为92.0%(23/25).结论全身DWI对转移瘤患者寻找原发灶的灵敏度高,可以作为寻找原发灶的筛查方法.
목적 탐토MR전신확산가권성상(DWI)심조전이류환자원발조적가행성화령민도.방법 전첨성분석34례이전이류증상취진,경CT、단광자발사계산궤체층성상혹MRI발현불명원발조적전이류환자진행전신DWI소묘,분별측량가의원발조화전이류적표관확산계수(ADC)치.대경활검혹수술병리증실적폐암환자,응용배대t검험비교원발조화전이류적ADC치.탐토전신DWI대원발조적검출솔화령민도.결과 통과대34례전이류환자전신DWI소묘,발현가의원발조24례,기중23례피증실위원발악성종류,1례가의원발조천자위량성병변;10례경전신DWI소묘미발현명학원발조,기중2례경활검명학원발조,8례경수방6～12개월잉미명학원발조.학진적14례폐암원발조화전이류적평균ADC치분별위(1.24±0.18)×10-3화(1.16±0.27)×103mm2/s,차이무통계학의의(t=1.28,P>0.05).전신DWI대원발조적검출솔위67.6%(23/34),령민도위92.0%(23/25).결론 전신DWI대전이류환자심조원발조적령민도고,가이작위심조원발조적사사방법.
Objective To evaluate the availability and sensitivity of MR whole body diffusion weighted imaging (DWI) in searching primary tumors in patients with metastases.Methods Thirty-four patients with symptoms of metastases and unknown primary leasions were scanned by whole body DWI.All the metastases cases were diagnosed by CT,single photon emission computed tomography(SPECT) or MRL For the cases of suspected primary tumors,apparent diffusion coefficient (ADC) values of the primary and metastatic lesions were measured respectively.For the cases with primary lung cancers and metastases proved by pathology of biopsy or surgical specimens,statistics analysis of ADC values of primary and metastatic lesions was performed with paired samples t-test.The detection rate and sensitivity of this technique for screening primary tumors were evaluated.Results By whole body DWI,24 cases were found with suspected primary lesions,in which 23 cases were proved primary tumors,and 1 case was proved benign lesion.Ten cases were not identified with primary lesions on whole body DWI,but in which 2 cases were proved primary malignant tumor by biopsy later,and the other 8 cases remained unknown within follow-up of half a year to one year.For the 14 definite cases of lung cancers,the average ADC values of primary and metastatic lesions was (1.24±0.18)×10-3 and(1.16±0.27)×10-3mm2/s,respectively (t=1.28,P>0.05).The detection rate and sensitivity of whole body DWI for searching primary tumors was 67.6% (23/34) and 92.0% (23/25),respectively.Conclusion The sensitivity of whole body DWI for searching primary tumors is relatively high,and it can be used to search primary tumors in patients with metastases.