Einarsdóttir Hildur, Karlsson Magnus, Wejde Johan, Bauer Henrik C F
Department of General Radiology-ADR, Karolinska Hospital, 171 76 Stockholm, Sweden.
Eur Radiol. 2004 Jun;14(6):959-63. doi: 10.1007/s00330-004-2237-0. Epub 2004 Feb 6.
The purpose of this study was to evaluate the clinical utility of a multi-shot spin-echo echo-planar (SE-EPI) diffusion-weighted sequence in the diagnostic work-up of soft tissue tumours. There were 29 patients, 16 with a benign lesion and 13 with a sarcoma. Four of the sarcomas were examined both before and after radiation therapy. Diffusion-weighted imaging was performed with a multi-shot SE-EPI sequence. The b values were 0 and 600 s/mm(2). Phase navigation and pulse trigging were applied. The apparent diffusion constant (ADC) value of a large region of interest (ROI) representing the lesion was measured and compared to diagnosis and treatment. The ADC values of the benign lesions (mean 1.8 x 10(-3) mm(2)/s) overlapped with non-treated sarcomas (mean 1.7 x 10(-3) mm(2)/s). The ADC value increased in all radiated sarcomas. A multi-shot SE-EPI diffusion imaging sequence of less than 2-min duration is technically feasible in soft tissue tumours of the extremities and the trunk. The ADC values of benign soft tissue tumours and sarcomas overlapped and could not be used to differentiate between the bulk of benign and malignant tumours. However, the increase in ADC values of soft tissue sarcomas after radiotherapy warrants further studies of diffusion imaging for evaluating therapy response.
本研究的目的是评估多次激发自旋回波平面回波（SE-EPI）扩散加权序列在软组织肿瘤诊断检查中的临床应用价值。共有29例患者，其中16例为良性病变，13例为肉瘤。4例肉瘤患者在放疗前后均接受了检查。采用多次激发SE-EPI序列进行扩散加权成像。b值为0和600 s/mm²。应用了相位导航和脉冲触发技术。测量代表病变的大感兴趣区（ROI）的表观扩散常数（ADC）值，并与诊断和治疗情况进行比较。良性病变的ADC值（平均1.8×10⁻³ mm²/s）与未治疗的肉瘤（平均1.7×10⁻³ mm²/s）重叠。所有接受放疗的肉瘤的ADC值均升高。持续时间小于2分钟的多次激发SE-EPI扩散成像序列在四肢和躯干的软组织肿瘤中技术上是可行的。良性软组织肿瘤和肉瘤的ADC值重叠，无法用于区分大多数良性和恶性肿瘤。然而，软组织肉瘤放疗后ADC值的升高值得进一步研究扩散成像以评估治疗反应。
