中国癌症杂志
中國癌癥雜誌
중국암증잡지
CHINA ONCOLOGY
2014年
3期
187-196
,共10页
沈茜刚%周良平%彭卫军%毛健%张灵%姚之丰%程竞仪%刘晓航%丁建辉%岳磊
瀋茜剛%週良平%彭衛軍%毛健%張靈%姚之豐%程競儀%劉曉航%丁建輝%嶽磊
침천강%주량평%팽위군%모건%장령%요지봉%정경의%류효항%정건휘%악뢰
扩散加权成像%背景抑制扩散加权成像%磁共振成像%骨转移%核素骨扫描
擴散加權成像%揹景抑製擴散加權成像%磁共振成像%骨轉移%覈素骨掃描
확산가권성상%배경억제확산가권성상%자공진성상%골전이%핵소골소묘
Diffusion weighted imaging%Diffusion-weighted whole-body imaging with background body signal suppression%MR Imaging%Bone metastasis%Bone scintigraphy
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。
揹景與目的:揹景抑製擴散加權成像(diffusion-weighted whole-body imaging with background body signal suppression,DWIBS)是一種可用于全身檢查的MR成像技術,可以較好地顯示淋巴結及骨骼繫統病變,其成像效果與PET類似。本研究旨在探討DWIBS與覈素骨掃描成像在骨轉移性病變診斷中的臨床應用價值。方法:36例經手術或穿刺病理證實為噁性腫瘤的患者行DWIBS及覈素骨掃描檢查,比較兩者檢齣骨轉移的情況,採用χ2檢驗,P<0.05為差異有統計學意義。結果:36例噁性腫瘤患者中,30例(共165處)髮生骨轉移,其中DWIBS檢齣26例(143處),覈素骨掃描檢齣23例(132處),兩者在檢齣骨轉移方麵差異無統計學意義(χ2=1.002,P=0.506)。DWIBS及覈素骨掃描診斷骨轉移的靈敏度、暘性預測值、準確度較為接近,分彆為86.7%、96.3%、86.1%和76.7%、88.5%、72.2%;DWIBS診斷骨轉移的特異度、陰性預測值高于覈素骨掃描,分彆為83.3%、55.6%和50.0%、30.0%。分析DWIBS和覈素骨掃描檢齣骨轉移的部位,兩者的檢齣率分彆為86.7%(143/165)、80.0%(132/165),差異無統計學意義(χ2=2.640,P=0.104);但DWIBS在檢齣骨盆及四肢長骨轉移方麵優于覈素骨掃描,且兩者差異均有統計學意義(χ2=6.783和7.636,P=0.023和0.016)。結論:運用DWIBS掃描技術可有效檢齣骨轉移性病竈,且與覈素骨掃描具有較好的一緻性,有望在臨床上推廣應用。
배경여목적:배경억제확산가권성상(diffusion-weighted whole-body imaging with background body signal suppression,DWIBS)시일충가용우전신검사적MR성상기술,가이교호지현시림파결급골격계통병변,기성상효과여PET유사。본연구지재탐토DWIBS여핵소골소묘성상재골전이성병변진단중적림상응용개치。방법:36례경수술혹천자병리증실위악성종류적환자행DWIBS급핵소골소묘검사,비교량자검출골전이적정황,채용χ2검험,P<0.05위차이유통계학의의。결과:36례악성종류환자중,30례(공165처)발생골전이,기중DWIBS검출26례(143처),핵소골소묘검출23례(132처),량자재검출골전이방면차이무통계학의의(χ2=1.002,P=0.506)。DWIBS급핵소골소묘진단골전이적령민도、양성예측치、준학도교위접근,분별위86.7%、96.3%、86.1%화76.7%、88.5%、72.2%;DWIBS진단골전이적특이도、음성예측치고우핵소골소묘,분별위83.3%、55.6%화50.0%、30.0%。분석DWIBS화핵소골소묘검출골전이적부위,량자적검출솔분별위86.7%(143/165)、80.0%(132/165),차이무통계학의의(χ2=2.640,P=0.104);단DWIBS재검출골분급사지장골전이방면우우핵소골소묘,차량자차이균유통계학의의(χ2=6.783화7.636,P=0.023화0.016)。결론:운용DWIBS소묘기술가유효검출골전이성병조,차여핵소골소묘구유교호적일치성,유망재림상상추엄응용。
Background and purpose:Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) can be used for MR imaging systemic examination, especially the lymph node and bone diseases can be clear, and the imaging result is similar with PET. The aim of this study was to compare the value of clinical application in the diagnosis of malignant metastatic osteopathic between DWIBS and bone scintigraphy mapping. Methods:Thirty-six specimens conifrmed with malignant tumors by the pathology of operation or biopsy underwent both DWIBS imaging and bone scintigraphy mapping, chi-square test was used for comparing the detection results of bone metastasis by this two imaging methods. Results:Thirty (165 positions in all) of 36 malignant tumor patients were conifrmed as having bone metastasis, compared that 26 patients (143 positions) with DWIBS method and 23 patients (132 positions) with bone scintigraphy mapping were detected, but there was no statistical signiifcance between this two imaging methods (χ2=1.002, P=0.506). The sensitivity, positive predictive value (PPV) and accuracy of the detection rate of bone metastasis were similar in DWIBS and bone scintigraphy, with 86.7%, 96.3%, 86.1%and 76.7%, 88.5%, 72.2%, respectively;but the speciifcity and negative predictive value (NPV) in DWIBS (83.3%and 55.6%) was higher than that of in bone scintigraphy (50.0%and 30.0%). The detection rates of different bone metastasis with DWIBS and bone scintigraphy were 86.7%(143/165) and 80.0%(132/165), and it was no signiifcant difference (χ2=2.640, P=0.104);DWIBS method was better than bone scintigraphy in the detection of osseous metastasis on pelvis and limbs long bone, and there was different signiifcant (χ2=6.783 and 7.636, P=0.023 and 0.016). Conclusion:DWIBS could detect bone metastatic lesions effectively, and there is ifne consistency with bone scintigraphy. Therefore, DWIBS is to hope to be extended and applicated clinically.