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The Technology of Whole Body Diffusion Weighted Imaging (WB-DWI) and Its Application in Diagnosis of Tumor

Author: YangTianHe
Tutor: ZhangYunTing
School: Tianjin Medical University
Course: Medical Imaging and Nuclear Medicine
Keywords: DWI Whole-body imaging STIR Tumor imaging Apparent diffusion coefficient Tumor
CLC: R445.2
Type: Master's thesis
Year: 2010
Downloads: 103
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Abstract


The first part of the whole body magnetic resonance diffusion weighted imaging technology improvements and parameter optimization breathe freely state the purpose of the feasibility study, short TI inversion recovery echo-planar diffusion-weighted imaging sequences (STIR-EPI-DWI) and general coil body magnetic resonance Diffusion-weighted imaging (whole body Diffusion Weighted Imaging, WB-DWI). The resulting image then the maximum intensity projection (maximum intensity projection, MIP) reconstruction, the effect of class PET image, and then observed restricted diffusion in various parts of the body, by exploring the optimization of the method of technological improvements and scan parameters to understand the method body tumor imaging and the feasibility of the clinical diagnosis. Materials and methods ① to optimize the center frequency (center frequency CF) as systemic scan CF. ② b = 400 s/mm2 s/mm2 600 and 800 s/mm2 STIR-EPI-DWI scans, (3) compare the three sequences resultant dispersion tumor SNR (signal to noise ratio, SNR) of the image, contrast to noise ratio (contrast to noise ratio, CNR), and the detection rate of lesions. Compare STIR-EPI-DWI raw data image with the same level T2WI image SNR and CNR. The same time, 60 patients underwent coronal STIR sequence scan for fat-suppressed image, to the naked eye and STIR-EPI-DWI. Results uniform center frequency is to take the average of the first and third center frequency. B value 600s/mm2 STIR-EPI-DWI sequence image SNR and CNR of 60.94 ± 14.69 and 56.03 ± 11.82. B value 400s/mm2 STIR-EPI-DWI sequence image SNR and CNR of 58.76 ± 17.45 and 48.9 ± 13.54. STIR-EPI-DWI sequence with b value of 800 s/mm2 image SNR and CNR of 56.40 ± 17.27 and 51.32 ± 15.11. B value of 600 s/mm2 best results, the reconstructed 3D MIP can be fully demonstrated in patients with lesions. STIR sequence of body fat suppression coronal plane like multi-segment acquisition and post-processing layer by layer image stitching, also be used for diagnosis, but a huge time-consuming and difficult to apply, in practical work. The right conclusions CF image quality is essential. b value higher dispersion difference, but the higher the b value, the image signal-to-noise ratio is lower, affect the sharpness of the image. B value 600 s/mm2 appropriate. The improvement of the pre-scanning technology can be successfully obtain stable and high resolution WB-DWI image WB-DWI use STIR technology can inhibit signal contamination caused by the fat and muscle tissue. The second part of the normal adult body magnetic resonance diffusion weighted imaging ADC value of quantitative research purposes to investigate the dispersion characteristics of normal adult tissues and organs, the establishment of the different organs of the apparent diffusion coefficient (ADC) value of the standard and its relationship with gender, age . Materials and Methods 20 healthy volunteers, 10 cases each for men and women, age 41-50 years, mean age 47.5 years old. Short TI inversion recovery echo-planar sequence (STIR-EPI) line WB-DWI check b values ??of 0 and 600 s/mm2. Were measured in brain gray matter and white matter, head of caudate nucleus, putamen, thalamus, pons, bilateral submandibular gland, bilateral parotid gland, the left ventricular wall, the greater curvature of the stomach wall of the gastric body, the liver (left, right lobe), spleen, the head of the pancreas, both kidneys, T8 vertebral body, T5-9 disc, L2 vertebral body, L2-3 disc, prostate central zone and the peripheral zone, bilateral breast, uterus and uterine cavity ADC values, ADC of different gender groups The difference between the values ??used for statistical analysis. Results The mean ADC value of the various organs in middle-aged healthy people fluctuation. Bilateral cerebral gray matter, white matter, head of caudate nucleus and bilateral kidney, breast and liver left, the right lobe of the ADC value is no significant difference in ADC values ??no gender differences between men and women. Conclusion by measuring the main organs of normal middle-aged ADC values, the various organs ADC value of the standard, the ADC values ??of normal organs and tissues with sex and side no significant difference in body the DWI image evaluation and semi-quantitative analysis provides reference. The third part of the whole body magnetic resonance diffusion weighted imaging to explore the purpose for which the diagnosis of malignant tumors of the value of WB-DWI detection accuracy of the tumor and its metastatic foci. Materials and Methods 68 cases have been found in the primary tumor and metastases found that patients with multiple tumor lesions, but the primary tumor is not clear, WB-DWI check. Among them were 49 males and 19 females, with a median age of 61 years. 68 patients were compared with CT and / or MRI test results, of which 17 were compared with the test results of the PET. Lesion detection rate, the size of the lesion diameter is divided into: LT; 1cm ≥ 1 - lt; 2 cm, ≥ 2 - lt; 3 cm and ≥ 3cm four groups count, at the same time on different parts of the lesions detection analysis. Sensitivity WB-DWI lesions four groups were 30%, 78%, 96% and 100%, respectively. Highest in sensitivity and accuracy in the various parts of the bone. The diagnosis of lesions less than 1 cm in the lungs and lymph nodes in the neck, pelvic less than 2 cm, there are certain difficulties. The results show, the WB-DWI screening of a wide range of tumor lesions is safe, simple, effective and economical inspection method. Conclusion With the further improvement of the technical parameters, WB-DWI in the discovery and diagnosis of systemic multiple tumors, with good development potential.

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