摘要
目的 研究磁共振全身弥散成 像(WB-DWI)在恶性肿瘤诊断中的应用价 值。方法 选取我院2013年2月至2016年8 月临床疑似恶性肿瘤患者38例设置为观察 组,选取同期在我院接受体检的正常健 康志愿者12例设置为对照组,对两组均 进行磁共振全身弥散成像检查,并于一 周内对病变处行常规磁共振成像(MRI)检 查,分析两组WB-DWI成像特点。结果 38 例临床疑似恶性肿瘤患者最终诊断为恶 性肿瘤的30例,良性病变8例,WB-DWI诊 断恶性肿瘤29例,漏诊1例,WB-DWI诊断 恶性肿瘤的敏感度为93.33%,特异度为 87.50%,假阴性率为12.50%,假阳性率为 6.67%,阳性预测值为96.67%,阴性预测 值为77.78%,符合率为92.11%。良性肿瘤 病灶的最大平均弥撒系数值(ADC)、最小 平均ADC值、平均ADC值较恶性肿瘤均显著 较高(P<0.05)。结论 WB-DWI在体部性肿 瘤筛查中有一定的临床价值,对良恶性肿 瘤分辨率较高,能帮助临床尽早制定肿瘤 治疗方案,及早采取有效的治疗措施,最 大程度的延长患者生存期。
Objective To study the value of magnetic resonance whole body diffusion weighted imaging(WB-DWI) in the diagnosis of malignant tumors. Methods From February 2013 to August 2016, 38 patients with suspected malignant tumors in our hospital were selected as the observation group, and 12 normal healthy volunteers were selected as the control group at the same time. Both groups were examined by WBDWI, and the lesions were examined by conventional magnetic resonance imaging (MRI) within one week. The WB-DWIcharacteristics of the two groups were analyzed. Results Among 38 patients with suspected malignant tumors, there were 30 cases diagnosed with malignant tumors and 8 cases with benign lesions. WB-DWI diagnosed malignant tumors in 29 cases and 1 case was not diagnosed. The sensitivity, specificity, false negative rate, false positive rate the positive predictive value, negative predictive value and the coincidence rate of WB-DWI in the diagnosis of malignant tumors were 93.33%, 87.50%, 12.50%, 6.67%, 96.67%, 77.78% and 92.11%. The maximum mean diffusion coefficient (ADC) value, the minimum mean ADC value and the mean ADC value of benign tumors were significantly higher than those of malignant tumors (P<0.05). Conclusion WB-DWI is of certain clinical value in the screening of tumors in body, and the accuracy in the differential diagnosis of benign and malignant tumors is high. It can help the development of clinical treatment and prolong the survival time of the patients to the maximum extent.
【关键词】磁共振;全身弥散成像;恶性 肿瘤;诊断
【中图分类号】R73;R445.2
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2018.02.037
前言
恶性肿瘤是严重影响人类生命健康的疾病之一,肿瘤生长不受机 体生理调节,特别是恶性肿瘤呈浸润性快速生长,且易发生转移,导 致患者组织出血、坏死、溃疡等,严重损害脏器正常功能,最终造成 患者死亡[1]。肿瘤原发灶及其转移灶的早期发现有利于临床有效的治 疗方案的制定,对改善患者预后有种重要意义,影像学检查是对肿瘤 病灶及转移灶进行筛查的主要手段,更加受到临床重视[2]。目前临床 应用于肿瘤影像学检查的方法很多,正电子发射计算机断层显像(PET) 成像技术能为临床诊断提供大量有效的恶性肿瘤信息,但是其检查费 用高昂且伴有电离辐射危险,并不适合临床广泛应用[3]。WB-DWI是新 发展起来的磁共振功能成像技术,敏感性高,且无辐射,作用类似于 “PET”技术,能敏感的探测肿瘤性病变[4-5]。因此本次研究特选取我 院38例临床疑似恶性肿瘤患者和12例正常健康志愿者,均进行WB-DWI 检查,现将结果报告如下。
中国CT和MRI杂志
第16卷, 第 2 期
2018年02月
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