CAJ | 학술논문

目的评估磁共振全身弥散加权成像（whole Body diffusion-weighted imaging，WB-DWI）在转移瘤的应用价值。方法分类对比分析50例肿瘤患者WB-DWI和CT图像中的异常信号和异常密度病灶。结果在呼吸系统中，WB-DWI发现51处肺门周围转移瘤，未能发现57处肺内体积较小的瘤灶，而CT均能发现，说明对于肺内转移病灶的检出敏感性差。在腹部实质器官中，WB-DWI发现的88剟．9％的转移灶CT能够清晰显示，而11．1％的转移灶CT却未能显示；在骨骼系统中，WB-DWI发现474处异常信号， CT仅发现307处骨组织异常改变，其中9例患者有56处骨组织呈WB-DWI异常信号而CT显示正常，数月后CT复查，相应部位均出现骨质破坏；说明在腹部实质脏器和骨骼系统中WB-DWI比CT更多更早发现肿瘤病灶，并且具有很高的准确性。在淋巴系统中， CT图像上25处大于1 cm的淋巴结在DWI图像上未显示，而CT图像上74处小淋巴结在WB-DWI图像上却呈高信号，部分经病理证实为淋巴转移。结论WB-DWI技术适用于健康查体及恶性肿瘤全身转移的筛查，对于淋巴结定性诊断能够提供有价值的信息。
목적평고자공진전신미산가권성상（whole Body diffusion-weighted imaging，WB-DWI）재전이류적응용개치。방법분류대비분석50례종류환자WB-DWI화CT도상중적이상신호화이상밀도병조。결과재호흡계통중，WB-DWI발현51처폐문주위전이류，미능발현57처폐내체적교소적류조，이CT균능발현，설명대우폐내전이병조적검출민감성차。재복부실질기관중，WB-DWI발현적88철．9％적전이조CT능구청석현시，이11．1％적전이조CT각미능현시；재골격계통중，WB-DWI발현474처이상신호， CT부발현307처골조직이상개변，기중9례환자유56처골조직정WB-DWI이상신호이CT현시정상，수월후CT복사，상응부위균출현골질파배；설명재복부실질장기화골격계통중WB-DWI비CT경다경조발현종류병조，병차구유흔고적준학성。재림파계통중， CT도상상25처대우1 cm적림파결재DWI도상상미현시，이CT도상상74처소림파결재WB-DWI도상상각정고신호，부분경병리증실위림파전이。결론WB-DWI기술괄용우건강사체급악성종류전신전이적사사，대우림파결정성진단능구제공유개치적신식。
Objective To evaluate the application value of whole body diffusion-weighted imaging ( WB-DWI) in patients with metastatic tumor .Methods The abnormal signal and abnormal density focus showed by WB-DWI and CT images in 51 patients with metastatic tumor were classified and comparatively analyzed . Results In respiratory system , WB-DWI revealed 51 metastatic carcinomas around hilar nodes , however 57 smaller carcinomas within lungs were not found ,while CT could find these tumor focus ,which suggested that the detection sensitivity of WB-DWI was worse for smaller metastatic carcinomas within lungs .In abdominal solid organs,89%of metastases could be detected by WB-DWI,which could also be clearly revealed by CT ,but the other 11.1%of them were not showed by CT.In skeletal system,WB-DWI found 477 abnormal signals,however, CT revealed only 309 abnormal changes of bone tissue ,in which 56 abnormal signals of bone tissues in 9 patients were showed by WB-DWI,however,which were showed normal by CT,after several months,CT scan showed bone destruction in corresponding site .The results suggested that WB-DWI could detect more and earlier tumor focus in solid organ and skeletal system,as compared with CT.In lymph system,25 lymph nodes (diameter>1cm) showed by CT were not detected by WB-DWI,however,74 smaller lymph nodes showed by CT were showed high signal on WB-DWI images,part of them was lymph metastasis identified by pathology .Conclusion WB-DWI is suitable for physical examination and screening for metastatic carcinomas in total body ,which can provide valuable information for qualitation diagnosis of lymph node .