Fujii Shinya, Matsusue Eiji, Kanasaki Yoshiko, Kanamori Yasunobu, Nakanishi Junko, Sugihara Shuji, Kigawa Junzo, Terakawa Naoki, Ogawa Toshihide
Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1, Nishi-cho, Tottori, Yonago, 683-8504, Japan.
Eur Radiol. 2008 Jan;18(1):18-23. doi: 10.1007/s00330-007-0732-9. Epub 2007 Aug 14.
The aim of this study is to evaluate the usefulness of diffusion-weighted (DW) magnetic resonance (MR) imaging in detecting peritoneal dissemination in cases of gynecological malignancy. We retrospectively analyzed MR images obtained from 26 consecutive patients with gynecological malignancy. Peritoneal dissemination was histologically diagnosed in 15 of the 26 patients after surgery. We obtained DW images and half-Fourier single-shot turbo-spin-echo images in the abdomen and pelvis, and then generated fusion images. Coronal maximum-intensity-projection images were reconstructed from the axial source images. Reader interpretations were compared with the laparotomy findings in the surgical records. Receiver-operating characteristic (ROC) curves were used to represent the presence of peritoneal dissemination. In addition, the sensitivity and specificity were calculated. DW imaging depicted the tumors in 14 of 15 patients with peritoneal dissemination as abnormal signal intensity. ROC analysis yielded Az values of 0.974 and 0.932 for the two reviewers. The mean sensitivity and specificity were 90 and 95.5%. DW imaging plays an important role in the diagnosis and therapeutic management of patients with gynecological malignancy.
本研究旨在评估扩散加权磁共振成像（DW-MRI）在检测妇科恶性肿瘤患者腹膜播散方面的实用性。我们回顾性分析了连续26例妇科恶性肿瘤患者的磁共振图像。26例患者中有15例术后经组织学诊断为腹膜播散。我们获取了腹部和盆腔的DW图像及半傅里叶单次激发快速自旋回波图像，然后生成融合图像。从轴位源图像重建冠状位最大强度投影图像。将阅片者的解读与手术记录中的剖腹探查结果进行比较。采用受试者操作特征（ROC）曲线来表示腹膜播散的存在情况。此外，还计算了敏感性和特异性。DW成像显示15例腹膜播散患者中有14例的肿瘤表现为异常信号强度。两位阅片者的ROC分析得出的Az值分别为0.974和0.932。平均敏感性和特异性分别为90%和95.5%。DW成像在妇科恶性肿瘤患者的诊断和治疗管理中发挥着重要作用。
