目的探讨全身弥散加权磁共振 成像(whole body diffusion-weighted MRI，WB-DWI)及其联合常规CT/MRI诊断恶 性肿瘤转移灶的临床应用价值。材料与 方法 对76例恶性肿瘤患者进行WB-DWI检 查，所有恶性肿瘤患者均在7天内完成常 规CT及MR检查。采用双盲法由两名资深 影像医师对所有WB-DWI图像以及CT、MR图 像进行分析。所有转移瘤均经手术或穿刺 后病理学检查、影像学资料、实验室检 查或随访至少3个月证实。统计单独应用 WB-DWI和WB-DWI联合常规CT/MRI对转移瘤 诊断的灵敏度、特异度和准确度；比较 两者在转移瘤的诊断中是否存在统计学 差异。结果 单独应用WB-DWI诊断转移瘤 的灵敏度为75.9%，特异度为25%，准确度 为69.8%；WB-DWI联合CT/MRI诊断转移瘤 的灵敏度为94.8%，特异度为67.5%，准确 度为91.5%。经卡方检验，两者对恶性肿 瘤全身转移灶的检出率具有统计学意义(P ＜0.05)。结论 WB-DWI联合CT/MRI是诊断 恶性肿瘤全身转移灶合理、有效的检查手 段，具有较高的临床应用价值。

Objective To explore the values of whole body diffusion-weighted MRI (WB-DWI) and WB-DWI in combination with conventional CT/MRI in diagnosis of metastases of malignant tumors. Materials and Methods 76 patients with malignant tumors underwent WB-DWI examinations. Patients with malignant tumors underwent conventional CT and MRI examinations within a week, few of which underwent enhanced CT OR MRI scan. Two experienced imaging physicians analyzed all of WBDWI, CT and MR images by double-blind method. All metastases were confirmed by surgery or puncture pathology, imaging data and laboratory tests or follow-up at least 3 months. The sensitivity, specificity and accuracy in the diagnosis of metastases of WBDWI and WB-DWI in combination with conventional CT/MRI were compared. Results The sensitivity, specificity and accuracy in detecting systemic metastases from malignant tumors were 75.9%, 25%, 69.8% respectively by WB-DWI, and 94.8%, 67.5%, 91.5% respectively by WB-DWI in combination with conventional CT/MRI. By the chi-square test, there were statistical differences in detecting systemic metastases from malignant tumors between the two methods (P>0.05). Conclusion WB-DWI in combination with conventional CT/MRI is a reasonable and effective screening tool in detecting systemic metastases from malignant tumors, with high clinical value.