背景抑制MR全身扩散成像的临床应用 (类PET成像)资料讲解.pptVIP

a 44-year-old man with diffuse large B-cell lymphoma Coronal maximum intensity projection FDG-PET and DWIBS images before initiation of chemotherapy. FDG-PET and DWIBS images at the end of treatment show resolvement of all pre-existing lesions. 治疗前 治疗后 A limitation of DWIBS is that discrimination between normal and metastatic lymph nodes is still based on size criteria (箭头1); the FDG-PET positive left cervical lymph node cannot conclusively be identified as malignant on DWIBS (arrowhead 1). DWIBS also shows prominent bilateral inguinal lymph nodes (encircled) which are normal according to FDG-PET. On the other hand, thanks to its higher spatial resolution (虚线箭头),, DWIBS visualizes two separate cardiac lesions whereas FDG-PET shows only one large cardiac lesion (dashed arrow). DWIBS also allows better evaluation of the urinary tract (箭头2) than FDG-PET, where potential lesions can be obscured because of FDG accumulation. Note the physiological FDG uptake in the large intestine (箭), which should not be confused with persistent malignant lymphoma. Detection of tumor persistence or recurrence Differentiating persistent or recurrent tumor tissue from posttherapeutic change is important for correct patient management, but is often difficult with CT or anatomical MRI. Functional imaging techniques, such as PET may allow better differentiation. The less expensive DWIBS may also be of value. It can be hypothesized that persistent or recurrent tumor tissue will show a more restricted diffusion than treatment-related changes, mainly because of higher cellular density. recurrence of rectal cancer Drawbacks and limitations of DWIBS First, DWIBS does not exclusively visualize malignant tumors. Benign pathologies with restricted diffusion, such as abscesses, will also exhibit high signal on DWIBS source images. Furthermore, DWIBS not only visualizes pathological areas of restricted diffusion, but also several normal structures：脑、唾液腺、扁桃体、脾脏、胆囊、小肠、大肠、