CAJ | 학술논문

目的探讨1.5 TMR全身扩散加权成像(WBDWI)对恶性肿瘤的诊断能力,比较WBDWI与PET-CT对恶性肿瘤诊断能力的差异.方法 35例病理证实为恶性肿瘤的患者,行WBDWI及18氟-脱氧葡萄糖(18F-FDG) PET-CT检查,随诊时间超过6个月,以病理及临床随诊为诊断金标准.测量ADC值、18F-FDG最大标准摄取值(SUVmax)及以e为底的ADC值的对数(eADC,仅用于绘制ROC曲线).比较WBDWI、PET-CT 2种方法诊断能力的评价指标采用敏感度、特意度、准确性,一致性的比较采用Kappa分析,曲线下面积的比较采用Hanley&McNeil法,分类资料用McNemar检验法或x2检验法.结果 35例患者病灶的WBDWI、PET-CT、eADC、SUVmax的ROC曲线下面积分别为0.952、0.970、0.844、0.858,WBDWI与PET-CT的ROC曲线下面积之间、eADC与SUVmax的ROC曲线下面积之间差异无统计学意义(Z=2.153、1.195,P＞0.05),WBDWI的ROC曲线下面积显著大于eADC(Z=7.456,P＜0.01),PET-CT的ROC曲线下面积显著大于SUVmax(Z =6.821,P＜0.01).WBDWI诊断的敏感度、特异度、准确率分别为86.6％、95.3％、89.5％,PET-CT敏感度、特异度、准确率分别为94.4％、94.3％、94.3％.WBDWI与PET-CT诊断一致性比较Kappa=0.745.结论 WBDWI诊断恶性肿瘤病变的敏感度、特异度、准确率较高,且与PET-CT诊断一致性较好.为辐射敏感的患者提供了一种选择.
목적 탐토1.5 TMR전신확산가권성상(WBDWI)대악성종류적진단능력,비교WBDWI여PET-CT대악성종류진단능력적차이.방법 35례병리증실위악성종류적환자,행WBDWI급18불-탈양포도당(18F-FDG) PET-CT검사,수진시간초과6개월,이병리급림상수진위진단금표준.측량ADC치、18F-FDG최대표준섭취치(SUVmax)급이e위저적ADC치적대수(eADC,부용우회제ROC곡선).비교WBDWI、PET-CT 2충방법진단능력적평개지표채용민감도、특의도、준학성,일치성적비교채용Kappa분석,곡선하면적적비교채용Hanley&McNeil법,분류자료용McNemar검험법혹x2검험법.결과 35례환자병조적WBDWI、PET-CT、eADC、SUVmax적ROC곡선하면적분별위0.952、0.970、0.844、0.858,WBDWI여PET-CT적ROC곡선하면적지간、eADC여SUVmax적ROC곡선하면적지간차이무통계학의의(Z=2.153、1.195,P＞0.05),WBDWI적ROC곡선하면적현저대우eADC(Z=7.456,P＜0.01),PET-CT적ROC곡선하면적현저대우SUVmax(Z =6.821,P＜0.01).WBDWI진단적민감도、특이도、준학솔분별위86.6％、95.3％、89.5％,PET-CT민감도、특이도、준학솔분별위94.4％、94.3％、94.3％.WBDWI여PET-CT진단일치성비교Kappa=0.745.결론 WBDWI진단악성종류병변적민감도、특이도、준학솔교고,차여PET-CT진단일치성교호.위복사민감적환자제공료일충선택.
Objectives To evaluate the diagnostic capability of whole-body diffusion-weighted imaging (WBDWI) with 1.5 T MR scanner in malignant lesions and compare it with 18F-FDG PETCT.Methods Thirty-five patients with pathologically proved malignant tumors were enrolled in this study.All patients underwent both WBDWI and PET-CT,and were followed up for more than 6 months.The final diagnosis was determined based on the results of pathology and clinical follow-up.The value of ADC and SUVm~ of each lesion were measured.The ROC curve,sensitivity,specificity and accuracy of the two methods were compared.Kappa analyses were used to compare the diagnostic consistency between both methods.Areas under the curve were compared by Hanley & McNeil.Categorical variables were tested with the Chi-square test or McNemar test.Results The area under the ROC curve of WBDWI,PET-CT,eADC,and SUVmax were 0.952,0.970,0.844 and 0.858,respectively.There was no significant statistical difference between WBDWI and PET-CT,eADC and SUVmax (Z =2.153,1.195,P ＞ 0.05),but Az (WBDWI) was significantly larger than Az(SUVmax) (Z =7.456,P ＜ 0.01),Az (PET-CT) was significantly larger than Az (SUV) (Z =6.821,P ＜ 0.01).The sensitivity,specificity and accuracy were 86.6％,95.3％ and 89.5％ in WBDWI,and 94.4％,94.3％ and 94.3％ in PET-CT.Kappa value of the diagnostic consistency between WBDWI and PET-CT was 0.745.Conclusions WBDWI had a high sensitivity,specificity and accuracy in detecting malignant lesions,and a substantial consistency with PET-CT,which could provide an appropriate choice for radiation-sensitive population.