摘要
目的 探讨磁共振弥散加权成像在脊柱转移瘤放疗中的诊断价值.方法 选择2020年2月至2023年2月在我院收治的60例脊柱转移瘤患者为对象,所有患者均实施强调放疗,分析磁共振弥散加权成像诊断结果.结果 60例患者在放疗前,常规磁共振成像(MRI)扫描可见82个病灶,累及椎体75个.在自旋回波(SE)T1加权成像(T1WI)诊断中,相比于周围正常椎体骨髓,病变呈低信号;在快速自旋回波脉冲序列(FSE)T2加权成像(T2WI)诊断中,混杂信号20例,略高或高信号62个;在DWI序列诊断中,共发现91个病灶,累积椎体82个,呈高信号.放疗前后MRI表现相比:在SE T1WI诊断中,脊髓转移瘤信号前略有下降或不变;在FSE T2WI诊断中,信号轻度下降40例,信号不变10例.所有患者化疗后,51例患者临床症状明显改善,与放疗前相比,弥散加权成像(DWI)信号降低.放疗前、放疗后脊柱转移瘤表观弥散系数(ADC)值均高于相邻正常椎体骨髓ADC值,差异有统计学意义(P＜0.05);放疗后脊柱转移瘤ADC值高于放疗前,差异有统计学意义(P＜0.05);放疗前后相邻正常椎体骨髓ADC值无统计学意义(P＞0.05).结论 磁共振弥散加权成像能提高脊髓转移瘤的检出率,并评估化疗效果,应用效果显著,值得临床推广.
Abstract
Objective To explore the diagnostic value of MR diffusion-weighted imaging in radiotherapy for spinal metastases.Methods Sixty patients with spinal metastases admitted to our hospital from February 2020 to February 2023 were selected.All patients received emphasized radiotherapy,and the diagnostic results of MR diffu-sion-weighted imaging were analyzed.Results Of 60 patients,82 lesions involving 75 vertebral bodies were visible on conventional MRI scans before radiotherapy.By spin echo(SE)T1WI diagnosis,the lesions had low signal compared with the surrounding normal vertebral bone marrow.By fast spin echo(FSE)T2WI diagnosis,20 cases had mixed sig-nals,and 62 had slightly higher or higher signals.By DWI sequence diagnosis,91 lesions were found,with 82 accu-mulated vertebral bodies with high signal.After chemotherapy in all patients,the clinical symptoms of 51 patients sig-nificantly improved,with reduced DWI signal compared with before radiotherapy.The ADC values of spinal metas-tases before and after radiotherapy were higher than those of adjacent normal vertebral bone marrow with statistical significance(P＜0.05),and the ADC values after radiotherapy were higher than those before radiotherapy(P＜0.05).There was no statistical significance in bone marrow ADC values of adjacent normal vertebrae before and after radio-therapy(P＞0.05).Conclusion Magnetic resonance diffusion-weighted imaging can improve the detection rate of spinal cord metastasis,and evaluate the effect of chemotherapy.
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