体素不相干运动扩散加权成像在鉴别头颈部鳞癌淋巴结转移中的应用

发布时间：2018-05-21 17:40

  本文选题：体素不相干运动 + 磁共振成像　； 参考：《临床放射学杂志》2016年05期

【摘要】：目的评价基于体素不相干运动(IVIM)模型计算出的真实扩散系数(D)、灌注相关扩散系数(D*)、灌注分数(f)和表观扩散系数(ADC)在鉴别头颈部鳞癌(HNSCC)淋巴结转移中的价值。方法回顾性分析2013年9月至2014年12月间HNSCC及良性淋巴结增生(LNH)患者46例临床资料,其中26例确诊HNSCC患者(男18例,女8例,平均年龄48岁)为A组,20例确诊LNH患者(男12例,女8例,平均年龄41岁)为B组。所有患者均进行3.0 T MR扫描,并于MR检查结束后2周通过手术或穿刺取得病理结果。IVIM-DWI采用13个b值。使用Mann-Whitney检验比较两组间D,D*,f和ADC值,用ROC曲线评价ADC、D和D*值的诊断效能。结果 A组共检出33个淋巴结,B组共检出22个淋巴结(最小直径均5 mm)。A组ADC值为(1.08±0.26)×10~(-3)mm~2/s,和B组(1.25±0.19)×10~(-3)mm~2/s相比,差异有统计学意义(P=0.035)。A组的D值为(0.57±0.12)×10~(-3)mm~2/s,B组为(0.74±0.21)×10~(-3)mm~2/s,A组较B组显著降低(P0.01)。A组的f值为0.20±0.02,B组为0.32±0.05,差异有统计学意义(P0.01);而A组D*值为(120.89±26.94)×10~(-3)mm~2/s,B组为(68.78±17.71)×10~(-3)mm~2/s,A组较B组显著增高(P0.01)。D*值的ROC曲线下面积(AUC)为0.952,大于D值(0.78)和ADC值(0.67)。结论 IVIM DWI技术在HNSCC淋巴结转移的鉴别诊断中是可行的,恶性淋巴结中降低的D值反映了高核浆比,而升高的D*值在一定程度上可反映恶性淋巴结增多的新生血管与组织灌注。
[Abstract]:Objective to evaluate the value of real diffusion coefficient (DG), perfusion correlation diffusion coefficient (PCD) and apparent diffusion coefficient (ADCC) in differentiating lymph node metastasis of head and neck squamous cell carcinoma (HNSCC) based on voxel incoherent motion (IVIMM) model. Methods the clinical data of 46 patients with HNSCC and benign lymphadenopathy between September 2013 and December 2014 were retrospectively analyzed. Among them, 26 patients with HNSCC (18 males and 8 females, mean age 48 years) were included in group A with 20 LNH patients (12 males). Group B consisted of 8 females with an average age of 41 years. All the patients underwent 3.0T Mr scan, and 13 b values were obtained by operation or puncture at 2 weeks after Mr examination. The Mann-Whitney test was used to compare the values of DMD and ADC between the two groups, and the ROC curve was used to evaluate the diagnostic efficacy of D D and D * values. Results A total of 33 lymph nodes were detected in group A and 22 lymph nodes were detected in group B (the ADC value of group B was 1.08 卤0.26) 脳 10 ~ (-1) 卤0.26 in minimum diameter of 5 mm).A, compared with that of group B (1.25 卤0.19) 脳 10~(-3)mm~2/s. 宸�寮傛湁缁熻�″�︽剰涔�(P=0.035).A缁勭殑D鍊间负(0.57卤0.12)脳10~(-3)mm~2/s,B缁勪负(0.74卤0.21)脳10~(-3)mm~2/s,A缁勮緝B缁勬樉钁楅檷浣，

本文编号：1920145