论文部分内容阅读
[目的]探讨磁共振弥散加权成像(DWI)对脊柱转移瘤放疗疗效的评估价值。[方法]收集30例脊柱转移瘤患者放疗前、后2个月的磁共振图像,所有患者均进行常规MRI及DWI序列。比较常规MRI序列与DWI序列对病灶的检出率。同时对照分析30例患者放疗前、后的DWI信号、ADC值。[结果]放疗前常规MRI扫描共发现病灶48个,累及42个椎体。DWI序列发现病灶56个,累及48个椎体。放疗结束后2个月复查MRI,SE T1WI上脊柱转移瘤信号不变或略有下降。FSE T2WI上20例信号轻度下降,10例不变。而在临床症状有改善的26例病例中,相对于放疗前,转移瘤DWI信号明显降低。在b=650s/mm2的DWI中,脊柱转移瘤放疗前表观扩散系数(ADC)值为(0.72±0.21)×10-3mm2/s,放疗后ADC值升高到(1.32±0.22)×10-3mm2/s;相邻正常椎体骨髓的ADC值较转移瘤低,且放疗前后没有变化。[结论]DWI序列既可以提高MRI对脊柱转移瘤的检出率,也可以用于监测和评估脊柱转移瘤的放疗疗效。
[Objective] To evaluate the value of magnetic resonance diffusion-weighted imaging (DWI) in radiotherapy of spinal metastases. [Methods] Magnetic resonance images of 30 patients with spinal metastases before and after radiotherapy were collected. All patients underwent MRI and DWI sequences. Compare the detection rate of conventional MRI sequence and DWI sequence to the lesion. At the same time, the DWI signals and ADC values of 30 patients before and after radiotherapy were analyzed. [Results] Before routine radiography, 48 lesions were found in conventional MRI scans, involving 42 vertebral bodies. Fifty-six DWI lesions were found, involving 48 vertebral bodies. MRI was reviewed 2 months after the end of radiotherapy and the signal of spinal metastases on SE T1WI was unchanged or slightly decreased. 20 cases of FSE T2WI signal decreased slightly, 10 cases unchanged. In 26 cases with improved clinical symptoms, the DWI signal of metastatic tumor was significantly lower than that before radiotherapy. In DWI with b = 650s / mm2, the apparent diffusion coefficient (ADC) of spinal metastases was (0.72 ± 0.21) × 10-3mm2 / s before radiotherapy, and the ADC value increased to (1.32 ± 0.22) × 10 -3mm2 / s; adjacent normal vertebral bone marrow ADC value is lower than the metastatic tumor, and did not change before and after radiotherapy. [Conclusion] DWI can not only improve the MRI detection rate of spinal metastases, but also can be used to monitor and evaluate the radiotherapy efficacy of spinal metastases.