MR全身弥散扫描在多发性骨肿瘤性病变中的应用研究

目的：探讨MR全身弥散扫描（WB-DWI）在多发骨转移瘤及骨髓瘤鉴别诊断中的应用价值。材料与方法：对57例多发骨肿瘤性病变患者（其中多发骨转移瘤47例，多发骨髓瘤10例）及12例正常志愿者进行WB-DWI检查。选取胸椎、腰椎及髂骨作为研究对象，分析正常志愿者及多发骨肿瘤性病变在WB-DWI上的信号特征，测量其ADC值范围，通过比较ADC值差异探讨WB-DWI在多发骨转移瘤和多发性骨髓瘤鉴别诊断中的价值。同时计算多发骨转移瘤患者通过WB-DWI找到原发灶的阳性病例数的比率。结果：与正常骨质相比，多发骨肿瘤性病变在WB-DWI表现为异常高信号。多发骨转移瘤病灶ADC值高于多发骨髓瘤，且两者的ADC值均明显高于正常骨质（P<0.01）。在多发骨转移瘤患者中，WB-DWI对原发灶的检出率为74.5%（35/47）。结论：通过比较多发骨转移瘤及多发骨髓瘤ADC值的差异，能为两种疾病的鉴别诊断提供一定的参考价值。WB-DWI对原发灶的显示，亦有助于两者的鉴别。

Applications of MR whole body DWI in multiple bone tumors

Objective: To investigate the value of whole body DWI(WB-DWI) in differential diagnosis of multiple bone metastases and multiple myeloma.Materials and Methods: Fifty-seven cases with multiple bone tumors and 12 cases normal volunteers underwent WB-DWI.Furthermore,the signal characteristic and ADC values of the thoracic,lumbar vertebrae,and llilac bone were analyzed and measured respectively.In addition,the detection frequency for searching primary tumors in patients with multiple osseous metastases was calc...