ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the value of whole-body diffusion weighted imaging (WB-DWI) on detection of malignant metastasis.</p><p><b>METHODS</b>Forty-six patients with malignant tumors underwent WB-DWI examinations between April 2007 and August 2007 in our hospital. Before WB-DWI examination, the primary cancers of all the patients were confirmed by pathology, and the TNM-stage was assessed with conventional magnetic resonance imaging (MRI) or computed tomography (CT). WB-DWI was performed using short TI inversion recovery echo-planar imaging (STIR-EPI) sequence. Abnormal high signal intensities on WB-DWI were considered as metastases. The results of WB-DWI were compared with other imaging modalities. For the assessment of the diagnostic capability of WB-DWI, WB-DWI were compared with CT for demonstrating mediastinal lymph node metastases and lung metastases, and with conventional MRI for demonstrating metastases in other locations.</p><p><b>RESULTS</b>WB-DWI demonstrated 143 focuses, 14 of which were diagnosed to be benign lesions in routine imaging. The number of bone metastases depicted on WB-DWI and routine imaging was 85 and 86; lymph node metastases was 17 and 18; liver metastases was 14 and 14; lung metastases was 4 and 8; and brain metastases was 6 and 8, respectively. WB-DWI failed to detect 12 metastatic lesions including 3 osteoplastic bone metastases, 4 lung metastases, 3 mediastinal lymph node metastases, and 2 brain metastases. Four metastatic lesions including 2 deltopectoral lymph nodes and 2 rib metastases were detected with WB-DWI alone, all of which evolved greatly during clinical follow-up for more than 6 months. WB-DWI had higher detection rates for metastatic lesions in liver, bone, and lymph nodes than those in lung and brain (chi2=30, P<0.001).</p><p><b>CONCLUSIONS</b>WB-DWI could detect most of metastatic lesions that were diagnosed with conventional MRI and CT. The limitations of WB-DWI might be had high false-positive rate and low efficiency in detecting mediastinal lymph node, brain, and lung metastases.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Bone Neoplasms , Brain Neoplasms , Diffusion Magnetic Resonance Imaging , Methods , Image Interpretation, Computer-Assisted , Methods , Liver Neoplasms , Lung Neoplasms , Lymphatic Metastasis , Neoplasm Metastasis , Diagnosis , Pathology , Neoplasms , Diagnosis , Pathology , Whole Body Imaging , MethodsABSTRACT
Objective To evaluate the clinical efficacy of percutaneous ultra-fine needle CO_2 splenoportography (CO_2-SP).Methods CO_2-SP and 3D-CE-MRA were performed in 36 patients.The imaging quality of the methods was compared by a scoring criterion setup based on the visualization of the trunk,intrahepatic branches of the portal vein and collateral vessels.Results Transient mild abdominal discomfort was presented in 19 patients(52.8% )receiving CO_2-SP.One patient developed snbcapsular splenic hematoma and was discharged with clinical stability several days later after conservative treatment. The imaging quality of the intrahepatic branches of the portal vein with CO_2-SP was much more superior to 3D-CE-MRA (the score was 232 and 198 respectively,t=4.52,P0.05 ).Conclusion Ultrafine needle CO_2-SP is a minimally invasive and safe procedure,able to provide dynamic and clearer imaging of the intrahepatic branches of the portal vein.