全身MR扩散加权成像在鉴别淋巴结肿大原因的应用研究

发布时间：2018-07-08 10:00

本文选题：淋巴结病变 + 淋巴瘤　；参考：《临床放射学杂志》2015年05期

【摘要】：目的探讨全身磁共振扩散加权成像(WB MR DWI)对初诊不明原因淋巴结肿大的鉴别诊断价值。方法经病理或临床证实的初诊淋巴结病变患者78例,其中淋巴瘤31例(淋巴瘤组),肿瘤转移性淋巴结病变30例(转移性淋巴结组),炎性淋巴结17例(炎性淋巴结组),所有患者均于治疗前行WB MR DWI检查,分别记录淋巴结病变个数并测量其表观扩散系数(ADC)值,应用独立样本t检验及受试者工作特征(ROC)曲线分析每两组病变的ADC值鉴别价值。结果淋巴瘤组、转移性淋巴结组及炎性淋巴结组平均ADC值分别为(1.197±0.388)×10-3mm2/s、(1.343±0.299)×10-3mm2/s和(1.677±0.466)×10-3mm2/s,淋巴瘤与转移性淋巴结组的平均ADC值均明显小于炎性组,淋巴瘤组的平均ADC值也小于转移性淋巴结组(P0.01),应用ROC曲线得出鉴别淋巴瘤与转移性淋巴结、淋巴瘤与炎性淋巴结、转移性淋巴结与炎性淋巴结及良、恶性淋巴结的ADC值鉴别诊断阈值分别为1.085×10-3mm2/s、1.575×10-3mm2/s、1.655×10-3mm2/s和1.575×10-3mm2/s,敏感性和特异性分别为41.5%、80.9%,78.6%、64.5%,84.5%、57.1%和78.2%、64.5%。结论 WB MR DWI结合ADC值对初诊不明原因淋巴结肿大原因有一定鉴别诊断价值,但对淋巴瘤与转移性淋巴结的鉴别价值有限。
[Abstract]:Objective to evaluate the value of diffusion-weighted imaging (WB Mr DWI) in differential diagnosis of newly diagnosed unknown lymphadenopathy. Methods 78 cases of newly diagnosed lymphadenopathy confirmed by pathology or clinic were studied. There were 31 cases of lymphoma (lymphoma group), 30 cases of metastatic lymph node lesion (metastatic lymph node group), 17 cases of inflammatory lymph node group (inflammatory lymph node group). The number of lymph node lesions was recorded and the apparent diffusion coefficient (ADC) values were measured. The differential value of ADC values in each group was analyzed by independent sample t test and ROC curve. Results the average ADC values of lymphoma group, metastatic lymph node group and inflammatory lymph node group were (1.197 卤0.388) 脳 10 ~ (-3) mm ~ (-2) / s, (1.343 卤0.299) 脳 10-3mm2/s and (1.677 卤0.466) 脳 10 ~ (-3) mm ~ (2 / s) respectively. The mean ADC value of lymphoma group was also lower than that of metastatic lymph node group (P0.01). ROC curve was used to distinguish lymphoma from metastatic lymph node, lymphoma from inflammatory lymph node, metastatic lymph node from inflammatory lymph node and good. The threshold of differential diagnosis of malignant lymph nodes was 1.085 脳 10 ~ (-3) mm ~ (-2) / s ~ 1.575 脳 10 ~ (-3) mm ~ (-2) / s = 1.655 脳 10-3mm2/s and 1.575 脳 10 ~ (-3) mm ~ (2) / s, respectively. Conclusion WB Mr DWI combined with ADC value has some value in differential diagnosis of unknown cause of lymphadenopathy, but it is limited in differentiating lymphomas from metastatic lymph nodes.
【作者单位】：福建省立医院放射科;复旦大学附属上海市第五人民医院放射科;
【基金】：上海市闵行区自然科学基金(编号:2012MHZ068)
【分类号】：R445.2;R733.1

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