背景抑制扩散加权成像与核素骨扫描在恶性肿瘤骨转移病变诊断中的对照研究

doi:10.3969/j.issn.1007-3969.2014.03.006

中国癌症杂志 ›› 2014, Vol. 24 ›› Issue (3): 187-196.doi: 10.3969/j.issn.1007-3969.2014.03.006

背景抑制扩散加权成像与核素骨扫描在恶性肿瘤骨转移病变诊断中的对照研究

沈茜刚¹,周良平¹,彭卫军¹,毛健¹,张灵¹,姚之丰²,程竞仪²,刘晓航¹,丁建辉¹,岳磊¹

1.复旦大学附属肿瘤医院放射诊断科，复旦大学上海医学院肿瘤学系，上海 200032；
2.复旦大学附属肿瘤医院核医学科，复旦大学上海医学院肿瘤学系，上海200032

出版日期:2014-03-31 发布日期:2014-04-01
通信作者: 周良平　E-mail:zhoulp-2003@163.com

A control study between DWIBS and bone scintigraphy mapping in the diagnosis of bone metastatic diseases

SHEN Xi-gang¹, ZHOU Liang-ping¹, PENG Wei-jun¹, MAO Jian¹, ZHANG Ling¹, YAO Zhifeng²,CHENG Jing-yi², LIU Xiao-hang¹, DING Jian-hui¹, YUE Lei¹

1.Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China;
2. Department of Nuclear Medicine, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

Published:2014-03-31 Online:2014-04-01
Contact: ZHOU Liang-ping E-mail: zhoulp-2003@163.com

摘要/Abstract

摘要：

背景与目的：背景抑制扩散加权成像(diffusion-weighted whole-body imaging withbackground 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。

关键词: 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

Abstract:

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 confirmed 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 confirmed 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 significance 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 specificity 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 significant 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 significant (χ2=6.783 and 7.636, P=0.023 and 0.016). Conclusion: DWIBS could detect bone metastatic lesions effectively, and there is fine consistency with bone scintigraphy. Therefore, DWIBS is to hope to be extended and applicated clinically.

Key words: Diffusion weighted imaging, Diffusion-weighted whole-body imaging with background body signal suppression, MR Imaging, Bone metastasis, Bone scintigraphy

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. 背景抑制扩散加权成像与核素骨扫描在恶性肿瘤骨转移病变诊断中的对照研究[J]. 中国癌症杂志, 2014, 24(3): 187-196.

SHEN Xi-gang, ZHOU Liang-ping, PENG Wei-jun, MAO Jian, ZHANG Ling, YAO Zhifeng,CHENG Jing-yi, LIU Xiao-hang, DING Jian-hui, YUE Lei. A control study between DWIBS and bone scintigraphy mapping in the diagnosis of bone metastatic diseases[J]. China Oncology, 2014, 24(3): 187-196.

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背景抑制扩散加权成像与核素骨扫描在恶性肿瘤骨转移病变诊断中的对照研究

A control study between DWIBS and bone scintigraphy mapping in the diagnosis of bone metastatic diseases

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