磁共振弥散加权成像和增强扫描在腹膜转移癌中的应用价值-影像医学与核医学专业论文.docxVIP

磁共振弥散加权成像和增强扫描在腹膜转移癌中的应用价值 磁共振弥散加权成像和增强扫描在腹膜转移癌中的应用价值 PAGE PAGE 10 结论: 常规 MRI、DWI、增强扫描序列均能应用在腹膜转移癌的诊断中，MRI 能显 示 PC 及其范围，同时检出其它原发病灶。常规 MRI 对腹膜转移癌的诊断效能较低，常 规 MRI+DWI 与常规 MRI+DWI+增强扫描对 PC 的诊断效能中等，但三者结合时 AUC 值最大，明显提高了诊断 PC 的灵敏度、特异度，为临床选择合理的影像学手段准确检 出 PC 提供了依据。 关键词: 磁共振弥散加权成像；磁共振增强扫描；腹膜转移癌；ROC 曲线 ABSTRACT Objective：To explore the efficacy of conventional magnetic resonance imaging (MRI), diffusion-weighted magnetic resonance imaging (DWI), and enhanced magnetic resonance imaging in diagnosing peritoneal carcinomatosis (PC), and summarize the MRI findings of PC. Methods: From September in 2013 to March in 2015, 43 patients with peritoneal carcinomatosis were included, which confirmed by surgical pathology or clinical follow-up in Gansu cancer hospital. All patients underwent MR examination (including T1WI, T2WI, DWI and enhanced magnetic resonance imaging). All of sequences were reviewed by two radiologists independently who were blinded to the results of the pathology and clinical follow-up. The following subjects were analyzed and recorded: (1) the lesion distribution and the MRI findings; (2) the sensitivity, specificity, positive predictive value and negative predictive of common MR sequences, common MR+DWI, common MR+DWI+ enhanced in diagnosing PC were calculated. And the corresponding receiver operator characteristic (ROC) curve were drawn by SPSS 20.0. Results: 1) Total of 28 patients with peritoneal carcinomatosis were enrolled. The MR findings of PC were as following: irregular linear thinckeing of parietal and visceral peritoneum (20), serosal thinckeing of the intestinal surface (2) , omental stranding and caking(10); mesentery stranding thickening(9); masses and nodules in the abdnominal cavitys(22); ascites(26); lymphadenopathy(8). The total number of lesion locations was 240, with the common sites of bilateral diaphragm, bilateral paracolic sulci (right more than left), omental, small omentum, peritoneum, and pot wall of uterine / bladder-rectal pouch. 2