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目的探讨背景抑制弥散成像(diffusion weighted imaging with background suppression,DWIBS)技术在肿瘤病变中的临床应用。方法分别利用SPIR及STIR 2种脂肪抑制技术对10例正常志愿者及临床、病理证实的20例肿瘤病变患者行DWIBS弥散成像检查,比较2组脂肪抑制技术对背景的抑制效果,观察正常人组DWIBS弥散成像表现及肿瘤病变DWIBS弥散信号特点,并计算病变的ADC值。结果STIR技术在颈部、胸部、脊柱、四肢等部位抑制背景效果较佳,SPIR在胸部、腹部、盆腔等部位抑制背景效果较佳,而在颈部、脊柱、四肢等部位背景抑制较差,图像信噪比(SNR)高于STIR。正常志愿组DWIBS弥散成像可清楚显示各类腺体、脾脏、外周神经(如臂丛结构等)以及淋巴结等结构。病变组20例中17例(85%)肿瘤病变显示清晰,DWIBS弥散呈高信号,反转类PET图呈低信号,3例肿瘤病变显示不满意,包括1例胰腺癌、1例直肠癌和1例前列腺癌。3例患者同时做了PET检查,2例对应良好,1例PET显示前列腺癌而弥散影像未显示。恶性肿瘤在b值=600 s/mm2时,ADC值最高为(1.58±2.06)×10-3mm2/s,最低为(0.88±0.74)×10-3mm2/s,平均ADC值(1.34±0.79)×10-3mm2/s。结论背景抑制弥散成像技术对肿瘤疾病的发现和诊断具有重要意义和广阔的应用前景。
Objective To investigate the clinical application of diffusion weighted imaging with background suppression (DWIBS) in tumor lesions. Methods Diffusion-weighted imaging (DWI) was performed on 10 normal volunteers and 20 patients with clinically and pathologically confirmed tumor lesions using SPIR and STIR respectively. The inhibitory effects of two groups of fat suppression techniques on the background were compared. The normal control group DWIBS diffuse imaging and tumor lesions DWIBS characteristics of diffuse signals, and calculate the lesion ADC value. Results The STIR technique had a better effect of suppressing the background in the neck, chest, spine and limbs. SPIR had better effect on the background of the chest, abdomen and pelvis but had less background suppression on the neck, spine and limbs, Image SNR (SNR) is higher than STIR. Normal volunteer group DWIBS diffusion imaging can clearly show all kinds of glands, spleen, peripheral nerves (such as brachial plexus structure, etc.) and lymph nodes and other structures. In 20 cases of lesion group, 17 cases (85%) showed clear tumor lesions, DWIBS diffuse high signal and inverted PET lesion showed low signal, 3 cases of tumor showed dissatisfactory, including 1 case of pancreatic cancer, 1 case of rectal cancer and 1 case of prostate cancer. Three patients underwent PET examinations at the same time, with 2 corresponding well, 1 PET showing prostate cancer and no diffuse images. The highest ADC value was (1.58 ± 2.06) × 10-3mm2 / s and the lowest was (0.88 ± 0.74) × 10-3mm2 / s when the b value was 600 s / mm2. The average ADC value was 1.34 ± 0.79 × 10 -3 mm 2 / s. CONCLUSIONS: Background diffusion suppression imaging is of great significance and broad application prospects for the detection and diagnosis of tumor diseases.