- 期刊
利用擴散加權影像輔助診斷骨骼肌肉系統惡性病灶－病例報告
Diffusion-weighted Imaging for Diagnosis of Malignant Musculoskeletal Lesions: A Case Report
摘要
擴散加權影像(diffusion-weighted imaging, DWI)是一種利用偵測水分子於組織間行隨機式擴散運動，造成訊號的變化所獲得之影像，現已廣泛應用於磁振造影腦部、腹部之病灶診斷。目前臨床上利用擴散加權影像診斷病變乃是因細胞密度、結構或是功能的改變，造成組織間水分子的擴散程度不同，藉由擴散的變化來偵測組織的結構並提供定性及定量組織訊息。本文案例為一名84歲男性因小腿腫瘤求診本院，經組織病理切片確診為黏液纖維肉瘤(Myxofibrosarcoma)，此為一好發於年長者四肢之惡性腫瘤，X光及電腦斷層檢 查顯示出腫瘤構成富涵纖維組織以及混合組織間液，臨床醫師為求精確診斷安排磁振造影檢查；磁振造影檢查除了常規檢查序列外，另包含擴散加權影像(diffusion- weighted imaging, DWI)，利用量測表觀擴散係數(apparent diffusion coefficient, ADC)值顯示其為惡性腫瘤機率極高，放射科醫師總結所有影像序列後診斷病灶為黏液纖維肉瘤(Myxofibrosarcoma)，其診斷結果與病理切片組織相符。藉由此例可以了解，擴散加權影像(diffusion-weighted imaging, DWI)於診斷骨骼肌肉系統惡性病灶有極大幫助。
並列摘要
Diffusion-weighted imaging (DWI) is a form of MR imaging based upon measuring the random Brownian motion of water molecules within a voxel of tissue. Nowadays, DWI has been widely used to diagnose neurological and abdominal lesions. Current DWI clinical use for the diagnostic purpose is due to the varying degrees change of water molecules in tissues, such as density, structure or function. By detecting changes in diffusion, DWI provides quantitative and qualitative lesion signals. This 84 years old male patient presented a calf mass to our hospital which was then proved to be a myxofibrosarcoma from the core-needle biopsy. This malignant tumor is most commonly occurs on the extremities of older people. Fibroblastic and histiocytic features composed the mass lesion in X-ray and CT scan revealed. For the accurately diagnose, doctor arranged MRI examination. We performed routine protocol conventional pulse sequences for the mass lesion, including the DWI. The mean ADC map showed highly suggestive of malignancy. The radiologist concluded the mass lesion by the all pulse sequence as a myxofibrosarcoma. In this case, the DWI is helpful to differentiate the musculoskeletal lesion.
延伸閱讀
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